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Background and Aims Lower limb amputation is a procedure usually performed under general or neuroaxial anaesthesia. However, in certain cases as patients in multiorgan failure, peripheral nerve blocks are the only viable alternative for anaesthesia.
Methods A 68-year-old male presented with an acute limb ischemia complicated by an infected ulcer leading to sepsis and multiorgan failure. The patient had a history of diabetes, myocardial infarction and triple vessel disease waiting for CABG. Considering the patient‘s cardiac condition, septic status, acute kidney injury, acute liver failure, general and spinal anaesthesia was deemed high risk. Therefore, a combination of iliac fascia, subgluteal sciatic and obturator blocks was proposed for anaesthesia to a life-saving transfemoral amputation. The procedure was carried out under sedation with dexmedetomidine and ketamine.
Results The patient had adequate anaesthesia and remained hemodynamically stable throughout the surgery and the postoperative period. Sedation in this procedure was required for the comfort of the patient and analgesia adjuvant.
Conclusions Sepsis induced multiorgan dysfunction is a challenge for the anaesthesiologist due to general and spinal anaesthesia side effects. Nerve blocks with sedation could be a safe alternative for anaesthesia in septic patients proposed for limb amputation.
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