Ultrasound-guided suprainguinal fascia iliaca block combined with a sacral plexus block for lower extremity surgery

Autor: Fan Tao, Yanming Huang, Mingjie Fu, Jie Zhao
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Hypertension
Pulmonary
Lumbosacral Plexus
Bone Nails
law.invention
Intramedullary rod
Pulmonary heart disease
Pulmonary Disease
Chronic Obstructive
03 medical and health sciences
0302 clinical medicine
Risk Factors
law
Fracture fixation
Humans
Medicine
Clinical Case Report
030212 general & internal medicine
Fascia
Tuberculosis
Pulmonary
Ultrasonography
Interventional
lower extremity surgery
business.industry
Nerve Block
General Medicine
Middle Aged
medicine.disease
Pulmonary hypertension
Femoral Neck Fractures
Fracture Fixation
Intramedullary
Sacral plexus
Surgery
Lumbosacral plexus
medicine.anatomical_structure
030220 oncology & carcinogenesis
Circulatory system
suprainguinal fascia iliaca block
Inguinal ligament
sacral plexus block
business
Research Article
Zdroj: Medicine
ISSN: 1536-5964
0025-7974
DOI: 10.1097/md.0000000000021921
Popis: Rationale: The anesthetic management of patients with severe pulmonary hypertension is different from that of normal, healthy patients, and regional nerve blocks are commonly used for them. Due to the individual variability of the course, distribution, and branching of the nerves below the inguinal ligament, the supra-inguinal fascia iliaca (SIFI) block has a wider and more stable blocking area. In combination with the sacral plexus block, they can satisfy the needs of surgical anesthesia below the hip. Patient concerns: A 46-year-old man with tuberculosis, chronic obstructive pulmonary disease, pulmonary heart disease, World Health Organization (WHO) class III pulmonary hypertension and right heart dysfunction, and American Society of Anesthesiologists physical status class III needed fixation of an intramedullary nail in the left lower extremity. Additionally, he had broken his left lower limb after a recent fall. Both general anesthesia and epidural anesthesia were not appropriate. Diagnoses: The patient had a clear history of tuberculosis, computerized tomography scan displayed destructive pneumonophthisis. Furthermore, he had chronic obstructive pulmonary disease and pulmonary heart disease. Interventions: An ultrasound-guided SIFI combined with a sacral plexus block was successfully performed for surgical anesthesia and avoided all hemodynamic fluctuations. Outcomes: We successfully performed an ultrasound-guided SIFI combined with a sacral plexus block for surgical anesthesia and avoided all hemodynamic fluctuations. Lessons: Ultrasound-guided suprainguinal fascia iliaca block combined with a sacral plexus block can be suitable for anesthesia for patients with severe circulatory compromise.
Databáze: OpenAIRE
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