Ultrasound-guided femoral nerve, femoral branch of genitofemoral nerve and sciatic nerve block for femoro-popliteal or tibial arterial bypass surgery on patients with cardiac dysfunction: Report of two cases

Heo, Burn Young; Gwak, Mi Sook; Jung, Jae Woong; Oh, Eun Jung; Choi, Soo Joo; Lee, Sangmin Maria; Kim, Young Wook

Case Report

Spinal Pain

Anesthesia and Pain Medicine 2013;8(4):222-225.
Published online October 30, 2013.

Ultrasound-guided femoral nerve, femoral branch of genitofemoral nerve and sciatic nerve block for femoro-popliteal or tibial arterial bypass surgery on patients with cardiac dysfunction: Report of two cases

Burn Young Heo, Mi Sook Gwak, Jae Woong Jung, Eun Jung Oh, Soo Joo Choi, Sangmin Maria Lee, Young Wook Kim

¹Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. gwakms@skku.edu
²Department of General Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

We report two cases of high-risked patients with cardiac dysfunction undergoing femoro-popliteal or tibial arterial bypass surgery anesthetized by ultrasound guided peripheral nerve blocks; femoral nerve, femoral branch of genitofemoral nerve and sciatic nerve block. We used an anesthetic solution consisting of 0.375% ropivacaine with epinephrine. We provided sufficient surgical anesthesia. These nerve blockades provided stable intraoperative and postoperative hemodynamic status, which is valuable knowledge from the perspective of postoperative pain control as well as satisfaction of both patients and surgeons. We believe that femorosciatic nerve block with concurrent femoral branch block of genitofemoral nerve could be an excellent anesthetic choice for patients receiving femoro-popliteal or tibial arterial bypass surgery, especially in patients with cardiac dysfunction.

Key Words: Femoral nerve, Nerve block, Peripheral vascular disease, Regional anesthesia, Sciatic nerve, Ultrasonography