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CASE REPORT
Year : 2018  |  Volume : 8  |  Issue : 2  |  Page : 100-103

Ultrasound-guided peripheral nerve blocks in high-risk patients, requiring lower limb (Above and below knee) amputation


1 Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan
2 Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan

Correspondence Address:
Dr. Faisal Shamim
Department of Anaesthesiology, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi 74800
Pakistan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJCIIS.IJCIIS_60_17

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A case series of five high-risk patients with lower limb ischemia, sepsis, altered coagulation, and multi-organ dysfunction requiring emergent or urgent lower limb amputation is presented. Use of peripheral nerve blocks for below and above knee amputations is quite uncommon which provides better hemodynamic stability and pain management, especially in the very sick patients. The surgeries were successfully carried out under ultrasound-guided combined femoral and sciatic nerve blocks. All five patients obtained adequate level of block at the area of amputation. There were no complications related to anesthetic management. Patients remained hemodynamically stable and pain-free during surgery and postoperatively. Combined femoral-sciatic nerve block under ultrasound guidance is safe and satisfactory alternative anesthetic technique for such patients.


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