scholarly journals Successful use of ultrasound-guided peripheral nerve block for lower limb surgery in a patient with heart failure with reduced ejection fraction: a case report

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110452
Author(s):  
Jaewoong Jung ◽  
Misoon Lee ◽  
Yang-Hoon Chung ◽  
Sung-Hwan Cho
Keyword(s):  
Heart Failure ◽  
Sciatic Nerve ◽  
Ejection Fraction ◽  
Peripheral Nerve ◽  
Lower Limb ◽  
Peripheral Nerve Block ◽  
Ultrasound Guided ◽  
Reduced Ejection Fraction ◽  
Lower Limb Surgery ◽  
Fascia Iliaca Compartment Block

The number of patients with heart failure with reduced ejection fraction (HFrEF) is increasing. These patients have a reduced cardiorespiratory reserve. Therefore, preoperative evaluation is essential to determine the best type of anaesthesia to use in patients with HFrEF. A 70-year-old man with HFrEF was scheduled to undergo debridement of skin necrosis due to thrombotic occlusion of the right common iliac artery. He had undergone wound dressing changes under local anaesthesia every other day for several months, and treatment for heart failure was on-going. A sciatic nerve and fascia iliaca compartment block was performed under ultrasound guidance because of the patient’s cardiopulmonary function. After confirming adequate sensory blockage, surgery was performed without any haemodynamic instability or complications. Thereafter, debridement was performed twice more using the same block technique, and a skin autograft was also successfully performed. We successfully performed an ultrasound-guided sciatic nerve and fascia iliaca compartment block in a patient with HFrEF who was scheduled to undergo lower limb surgery. Peripheral nerve block is an alternative option for patients with HFrEF.

118. Ultrasound-Guided Continuous Sciatic Nerve Block for Postoperative Pain Treatment After Lower Limb Surgery

2008 ◽  
Vol 33 (Suppl 1) ◽  
pp. e115.2-e115
Author(s):  
A. Martinez Navas ◽  
R. Ortiz de la Tabla Gonzalez ◽  
T. Vazquez Gutierrez ◽  
P. Gomez Reja ◽  
M. Reina Molina ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sciatic Nerve ◽  
Nerve Block ◽  
Lower Limb ◽  
Pain Treatment ◽  
Sciatic Nerve Block ◽  
Ultrasound Guided ◽  
Lower Limb Surgery ◽  
Postoperative Pain Treatment

118: Ultrasound-Guided Continuous Sciatic Nerve Block for Postoperative Pain Treatment After Lower Limb Surgery

2008 ◽  
Vol 33 (5) ◽  
pp. e115-e115
Author(s):  
A MARTINEZNAVAS ◽  
R DELATABLAGONZALEZ ◽  
T VAZQUEZGUTIERREZ ◽  
P GOMEZREJA ◽  
M REINAMOLINA ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sciatic Nerve ◽  
Nerve Block ◽  
Lower Limb ◽  
Pain Treatment ◽  
Sciatic Nerve Block ◽  
Ultrasound Guided ◽  
Lower Limb Surgery ◽  
Postoperative Pain Treatment

Peripheral Nerve Block Catheter for Extremity Surgery

2013 ◽  
Author(s):  
Elizabeth Prentice
Keyword(s):  
Postoperative Pain ◽  
Peripheral Nerve ◽  
Postoperative Analgesia ◽  
Lower Limb ◽  
Club Foot ◽  
Peripheral Nerve Block ◽  
Pediatric Population ◽  
Severe Postoperative Pain ◽  
Peripheral Nerve Blockade ◽  
Lower Limb Surgery

Continuous peripheral nerve blockade (CPNB) can provide excellent postoperative analgesia. Many adult studies report the effectiveness of CPNB. Although not as widely adopted in pediatrics, several studies support its use. Its niche lies in provision of analgesia after major unilateral limb surgery with severe postoperative pain expected for 48 to 72 hours. Lower limb surgery of this type is more common than upper limb in the pediatric population. Examples include club foot repair, osteotomy, or resection of sarcoma. This chapter presents two cases where CPNB is a good option for postoperative analgesia.

scholarly journals Emergency Transfemoral Amputation in a Severely Sick and Hemodynamically Unstable Patient through Eco-Guided Peripheral Nerve Block: Case Report

2016 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Luis Flavio Franca V Muniz ◽  
Jessica Francisco Meireles ◽  
Daissuke Kajita ◽  
Melissa Ameloti G Avelino
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Peripheral Nerve ◽  
Nerve Block ◽  
Lower Limb ◽  
Peripheral Nerve Block ◽  
Anesthetic Technique ◽  
Ultrasound Guided ◽  
Borderline Patients ◽  
The Right

Critically ill and/or anticoagulated patients remain a great challenge for anesthesiologists regarding the anesthetic procedure. Its perioperative management should focus on organ preservation and avoid further damage. In this context, ultrasound-guided regional blocks are essential tools, as they avoid neuraxial invasion and deterioration in borderline hemodynamics, conferred by spinal anesthesia and general anesthesia, respectively. In this report, we present a case of a patient with septic shock, anticoagulated, and in need of an emergency surgical approach in the right lower limb in which ultrasound-guided peripheral nerve block was essential for a favorable outcome for the patient. Case Report: Patient in septic shock in need of amputation of the right lower limb at the level of the thigh, with unstable hemodynamics and severe respiratory conditions, undergoing ultrasound-guided peripheral nerve block, of the right femoral, sciatic and lateral cutaneous nerves of the thigh, as a single anesthetic technique. Conclusion: Regional anesthesia of the peripheral nerve guided by ultrasound as a unique anesthetic technique, performed by experienced professionals or under supervision, is effective and safe for lower limb surgical procedures. We suggest this approach, especially in hemodynamically borderline patients or seriously ill with or without anticoagulation.

Ultrasound-Guided Continuous Sciatic Nerve Block for Postoperative Pain Treatment After Lower Limb Surgery

2008 ◽  
Vol 33 (Sup 1) ◽  
pp. e115
Author(s):  
A. Martinez Navas ◽  
R. Ortiz de la Tabla Gonzalez ◽  
T. Vazquez Gutierrez ◽  
P. Gomez Reja ◽  
M. Reina Molina ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sciatic Nerve ◽  
Nerve Block ◽  
Lower Limb ◽  
Pain Treatment ◽  
Sciatic Nerve Block ◽  
Ultrasound Guided ◽  
Lower Limb Surgery ◽  
Postoperative Pain Treatment

Heart Failure with Preserved Ejection Fraction – A Review

2012 ◽  
Vol 9 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Otto A Smiseth ◽  
Anders Opdahl ◽  
Espen Boe ◽  
Helge Skulstad
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Heart Failure ◽  
The Elderly ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Objective Evidence

Heart failure with preserved left ventricular ejection fraction (HF-PEF), sometimes named diastolic heart failure, is a common condition most frequently seen in the elderly and is associated with arterial hypertension and left ventricular (LV) hypertrophy. Symptoms are attributed to a stiff left ventricle with compensatory elevation of filling pressure and reduced ability to increase stroke volume by the Frank-Starling mechanism. LV interaction with stiff arteries aggravates these problems. Prognosis is almost as severe as for heart failure with reduced ejection fraction (HF-REF), in part reflecting co-morbidities. Before the diagnosis of HF-PEF is made, non-cardiac etiologies must be excluded. Due to the non-specific nature of heart failure symptoms, it is essential to search for objective evidence of diastolic dysfunction which, in the absence of invasive data, is done by echocardiography and demonstration of signs of elevated LV filling pressure, impaired LV relaxation, or increased LV diastolic stiffness. Antihypertensive treatment can effectively prevent HF-PEF. Treatment of HF-PEF is symptomatic, with similar drugs as in HF-REF.

Evaluation of the Efficacy of ST2 and NT-proBNP in the Diagnosis and Prediction of Short- Term Prognosis in Heart Failure with Reduced Ejection Fraction

2017 ◽  
Vol 9 (04) ◽  
Author(s):  
Shivananda B Nayak ◽  
Dharindra Sawh ◽  
Brandon Scott ◽  
Vestra Sears ◽  
Kareshma Seebalack ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Biomarkers ◽  
Double Blind Study ◽  
Short Term ◽  
Double Blind ◽  
Reduced Ejection Fraction ◽  
The Mean ◽  
Design And Methods ◽  
The Relationship

Purpose: i) To determine the relationship between the cardiac biomarkers ST2 and NT-proBNP with ejection fraction (EF) in heart failure (HF) patients. ii) Assess whether a superiority existed between the aforementioned cardiac markers in diagnosing the HF with reduced EF. iii) Determine the efficacy of both biomarkers in predicting a 30-day cardiovascular event and rehospitalization in patients with HF with reduced EF iv) To assess the influence of age, gender, BMI, anaemia and renal failure on the ST2 and NT-proBNP levels. Design and Methods: A prospective double-blind study was conducted to obtain data from a sample of 64 cardiology patients. A blood sample was collected to test for ST2 and NT-proBNP. An echocardiogram (to obtain EF value), electrocardiogram and questionnaire were also obtained. Results: Of the 64 patients enrolled, 59.4% of the population had an EF less than 40%. At the end of the 30- day period, 7 patients were warded, 37 were not warded, one died and 17 were non respondent. Both biomarkers were efficacious at diagnosing HF with a reduced EF. However, neither of them were efficacious in predicting 30-day rehospitalization. The mean NT-proBNP values being: not rehospitalized (2114.7486) and 30 day rehospitalization (1008.42860) and the mean ST2 values being: not rehospitalized (336.1975), and 30-day rehospitalization. (281.9657). Conclusion: Neither ST2 or NT-proBNP was efficacious in predicting the short- term prognosis in HF with reduced EF. Both however were successful at confirming the diagnosis of HF in HF patients with reduced EF.

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