Emergency Transfemoral Amputation in a Severely Sick and Hemodynamically Unstable Patient through Eco- Guided Peripheral Nerve Block: Case Report

Luis Flavio Franca V Muniz1*, Jessica Francisco Meireles2, Daissuke Kajita3 and Melissa Ameloti G Avelino4

1Department of Anesthesiology, Emergency Hospital of Goiânia, HUGO, Brazil
2Department of Anesthesiology, Anesthesiology TEAM, Goiania, Brazil
3Department of Vascular Surgery, Emergency Hospital of Goiania - HUGO, Brazil
4Department of Otorhinolaryngology, PPGCS, HC/UFG, Brazil

^*Correspondance to: Luis Flávio França V Muniz 

 PDF  Full Text DOI: 10.25107/2474-1647.3270

Abstract

Critically ill and/or anticoagulated patients remain a great challenge for anesthesiologists regarding the anesthetic procedure. Its perioperative management should focus on organ preservation and avoid further damage. In this context, ultrasound-guided regional blocks are essential tools, as they avoid neuraxial invasion and deterioration in borderline hemodynamics, conferred by spinal anesthesia and general anesthesia, respectively. In this report, we present a case of a patient with septic shock, anticoagulated, and in need of an emergency surgical approach in the right lower limb in which ultrasound-guided peripheral nerve block was essential for a favorable outcome for the patient. Case Report: Patient in septic shock in need of amputation of the right lower limb at the level of the thigh, with unstable hemodynamics and severe respiratory conditions, undergoing ultrasoundguided peripheral nerve block, of the right femoral, sciatic and lateral cutaneous nerves of the thigh, as a single anesthetic technique. Conclusion: Regional anesthesia of the peripheral nerve guided by ultrasound as a unique anesthetic technique, performed by experienced professionals or under supervision, is effective and safe for lower limb surgical procedures. We suggest this approach, especially in hemodynamically borderline patients or seriously ill with or without anticoagulation.

Keywords

Regional anesthesia; SIRS; SEPSES; Ultrasound; Femoral nerve; Ischiatic 2 nerve; Postoperative pain; Analgesia; Neuro-axial

Cite the article

Muniz LFFV, Meireles JF, Kajita D, Avelino MAG. Emergency Transfemoral Amputation in a Severely Sick and Hemodynamically Unstable Patient through Eco-Guided Peripheral Nerve Block: Case Report. Clin Surg. 2021; 6: 3270..