Role of ultrasound guided continuos sciatic nerve blocks in a complicated case of vasopressor induced lower limb ischemic pain

Abstract

Acute limb ischemia (ALI) is defined as any sudden decrease in limb perfusion causing a potential threat to limb viability. We are presenting a case of vasopressor-induced ALI involving both the lower limbs in a patient with altered coagulation, thrombocytopenia, and severe cardiovascular dysfunction. It is challenging to provide pain relief to a very sick hemodynamically unstable patient. A continuous peripheral nerve block of the lower limb has been shown to provide multiple benefits. In this patient, we successfully placed ultrasound-guided bilateral sciatic nerve catheters for continuous pain relief up to 2 weeks, with no major complications during or after the procedure. This case highlights that continuous peripheral nerve catheters provide good analgesia in ALI and have a positive effect on microcirculation, hence to be more frequently used.