Popliteal Nerve Block as an Alternative to Spinal Anaesthesia for Ankle Surgery in Comorbid Patient- A Case Report

Abstract

In high-risk patients with significant cardiovascular and other systemic disorders, administration of central neuraxial block or general anaesthesia is usually associated with adverse haemodynamic effects and high perioperative mortality. This case report is about a 57-year-old male patient with known case of Diabetes Mellitus (DM) posted for lower limb debridement. He had comorbidities like cellulitis, sepsis, uncontrolled diabetes, multiorgan dysfunction and was haemodynamically unstable. Peripheral nerve blockade keeps the haemodynamic more stable as compared to central neuraxial blockade and general anaesthesia. Therefore, popliteal nerve block was given to the patient in prone position. Peripheral nerve locator was used and after eliciting the response of foot twitch local anaesthetic drug was deposited. Adequate sensory motor block was achieved and surgery was carried out uneventfully. Patient was vitally stable throughout the surgery. Thus, it was seen that peripheral nerve blocks are an effective alternative to central neuraxial blockade and general anaesthesia in high risk patients undergoing below knee surgeries.