Ultrasound guided psoas compartment block and sciatic nerve block for revision arthroplasty of the knee performed two times in a patient with ankylosing spondylitis

Ferda Yılmaz İnal,Fuat Akpınar,Hasan Koçoğlu,Korhan Özkan,Mesure Gül Nihan Özden,Senem Koruk

doi:10.3329/bjms.v19i4.46641

Ferda Yılmaz İnal, Fuat Akpınar + Show 4 more

Open Access

https://doi.org/10.3329/bjms.v19i4.46641

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Abstract

Anesthetic management including endotracheal intubation and neuroaxial blocks is challenging in patients with ankylosing spondylitis because of the stifness of vertebral joints. Peripheral blocks in these patients may be helpful although it is not common. A 56 year-old male patient with ankylosing spondylitis having the history of total knee arthroplasty and difficult airway management was operated for the contracted knee joint prosthesis. Anteromedialisation of tuberositas tibia was performed with combination of ultrasound guided psoas compartment block (PCB) and sciatic nevre block (SNB), and repeated forty days later because of the displacement of the osteotomy site. We conclude that PCB together with SNB may be performed for knee surgery in patients with severe ankylosing spondylitis. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.772-774

Highlights

Anesthetic management including endotracheal intubation and neuroaxial blocks is challenging in patients with ankylosing spondylitis because of the stifness of vertebral joints
Case A 56 year-old male patient having had the diagnosis of ankylosing spondylitis was planned to be operated for the contracted knee joint prosthesis
Demirel et al [8] combined psoas compartment block (PCB) and sciatic nevre block (SNB) with L1 paravertebral block, and compared it with unilateral spinal anesthesia for partial hip prosthesis in elderly patients, and reported these blocks to be as effective as spinal anesthesia

Summary

Introduction

Anesthetic management including endotracheal intubation and neuroaxial blocks is challenging in patients with ankylosing spondylitis because of the stifness of vertebral joints. Lumbosacreal blocks gain importance in the management of these patients when hip and/or knee surgery is needed, altough these are not commonly performed yet. We hereby report management of a patient with ankylosing spondylitis who underwent revision arthroplasty of the knee, two times within 40 days, with combination of ultrasound guided psoas compartment block (PCB) and sciatic nerve block (SNB).

Results

Conclusion