Title: Peripheral Nerve Blocks as Anaesthetic Choice for Asymptomatic Severe Aortic Stenosis for Emergency Lower Limb Surgeries: A Case Report

Authors: Dr Anu Ambooken MBBS MD, Dr Manu S MBBS MD

 DOI: https://dx.doi.org/10.18535/jmscr/v11i4.06

Abstract

Patients with severe aortic stenosis, whether symptomatic or not possess unique challenge to the anaesthetist . Both general anaesthesia and regional anaesthesia with central neuraxial blockade carry potential risks owing to a fixed cardiac output. Haemodynamic fluctuations associated with anaesthesia can be detrimental in these patients. They are at increased risk for intraoperative and post- operative complications given the severity of aortic stenosis. A clear intraoperative plan should be designed to manage the unique haemodynamics of these patients. We report a case of assymptomatic severe aortic stenosis posted for an urgent lower limb surgery. Ultra sound guided combined popliteal-sciatic and femoral nerve blocks were used as a sole anaesthetic technique. Patient was haemodynamically stable in the intra-operative as well as post operative period. Patient did not require any additional analgesic for about 10 hours post-operatively.

Keywords: Popliteal sciatic nerve block, Femoral nerve block, Aortic stenosis, Lower limb surgery

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Corresponding Author

Dr Manu S MBBS MD

Consultant Anesthesiologist St Thomas Hospital Chethipuzha, Kottayam, Kerala