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Neuromuscular Physiology and Pharmacology
Anesthesia and Pain Medicine 2011;6(3):270-274.
Published online July 30, 2011.
Femoral and sciatic nerve blocks for total knee replacement in an obese patient with a previous history of failed endotracheal intubation: A case report
Jong Hae Kim, Woon Seok Roh, Jin Yong Jung, Seok Young Song, Jung Eun Kim, Baek Jin Kim
Department of Anesthesiology and Pain Medicine, School of Medicine, Catholic University of Daegu, Daegu, Korea.
Peripheral nerve block has frequently been used as an alternative to epidural analgesia for postoperative pain control in patients undergoing total knee replacement. However, there are few reports demonstrating that the combination of femoral and sciatic nerve blocks (FSNBs) can provide adequate analgesia and muscle relaxation during total knee replacement. We experienced a case of successful FSNBs for a total knee replacement in a 66 year-old female patient who had a previous cancelled surgery due to a failed tracheal intubation followed by a difficult mask ventilation for 50 minutes, 3 days before these blocks. FSNBs were performed with 50 ml of 1.5% mepivacaine because she had conditions precluding neuraxial blocks including a long distance from the skin to the epidural space related to a high body mass index and nonpalpable lumbar spinous processes. This case suggests that FSNBs can provide a good alternative anesthetic method for total knee replacement.
Key Words: Femoral nerve, Intubation, Nerve block, Sciatic nerve, Total knee replacement

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