Author(s)

Ju Hyun Lee, Hyun Su Shin, Ki Yoon Kim, Ji Seon Jeong, Justin Sangwook Ko^*

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.

We report a patient with severe pulmonary arterial hypertension (PAH) undergoing tibio-talo-calcaneal fusion due to Charcot joint. Despite the advancement in the management of PAH, the risks of anesthesia, surgery, and postoperative morbidity and mortality still remain high. A 46-year-old female was presented with severe PAH and end stage renal disease requiring hemodialysis three times a week. Ultrasound-guided sciatic, femoral, and obturator nerve blocks were performed with 0.5% levobupivacaine 15 ml, 10 ml, and 5 ml, respectively. All the blocks were successful, and the patient underwent uneventful anesthesia and surgery. In addition, the postoperative pain control lasted for 15 h and the patient was discharged on POD 5 without any complications. Therefore, ultrasound-guided sciatic, femoral, and obturator nerve blocks are valuable alternative to the general or neuraxial anesthesia in patients with severe pulmonary hypertension.

Femoral Nerve Block, Obturator Nerve Block, Sciatic Nerve Block, Severe Pulmonary Hypertension, Ultrasound-Guided

Lee, J. , Shin, H. , Kim, K. , Jeong, J. and Ko, J. (2017) Combined Sciatic, Femoral, and Obturator Nerve Blocks for Ankle Surgery in a Patient with Severe Pulmonary Hypertension—A Case Report. Open Journal of Anesthesiology, 7, 203-209. doi: 10.4236/ojanes.2017.78022.