2025, Vol. 8, Issue 4, Part A
Sequential bilateral lower limb peripheral nerve blocks in a high-risk cardiac patient: A case report
Author(s): Mohit Suresh Matte, Venkateswaran G, Madhumitha Vijayaraghavan, Anukul A Kadam and Vaishnovi Gangadhar
Abstract: Percutaneous coronary intervention (PCI) is a common procedure used to treat coronary artery disease. Performing non-cardiac surgeries or invasive procedures shortly after stent placement increases the risk of stent thrombosis, particularly if the intervention occurs soon after the procedure. Patients with chronic heart failure and reduced ejection fraction face significant challenges during anesthesia. General anesthesia can lead to myocardial depression and hypotension, while spinal anesthesia may cause sympathetic blockade, resulting in cardiovascular instability. Patients with chronic heart failure and reduced ejection fraction encounter significant challenges when undergoing anesthesia. General anesthesia can lead to myocardial depression and hypotension, while spinal anesthesia may cause sympathetic blockade, resulting in cardiovascular instability. Regional anesthesia, particularly peripheral nerve blocks (PNBs), provides targeted sensory and motor blockade with minimal systemic effects. In bilateral lower peripheral nerve blocks, a major consideration when administering bilateral lower limb blocks is the risk of local anesthetic systemic toxicity (LAST) due to the larger total volume of the drug required. In this case report, we present the effective application of staged bilateral lower limb peripheral nerve blocks (PNBs) in a patient suffering from heart failure with reduced ejection fraction. This emphasizes the significance of dose fractionation, the use of ultrasound guidance, and the sequential administration approach in improving safety.
DOI: 10.33545/26643766.2025.v8.i4a.600
Pages: 28-32 | Views: 361 | Downloads: 170
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How to cite this article:
Mohit Suresh Matte, Venkateswaran G, Madhumitha Vijayaraghavan, Anukul A Kadam, Vaishnovi Gangadhar. Sequential bilateral lower limb peripheral nerve blocks in a high-risk cardiac patient: A case report. Int J Med Anesthesiology 2025;8(4):28-32. DOI: 10.33545/26643766.2025.v8.i4a.600
