Fascia Iliaca block as the sole anesthesia technique in a patient with recent myocardial infarction for emergency femoral thrombectomy

Parate, Leena Harshad; Channappa, Nagaraj Mungasuvalli; Pujari, Vinayak Seenappa; Iyer, Sadasivan S

doi:10.4103/1658-354x.152886

Cited by 3 publications

(6 citation statements)

References 8 publications

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“…Furthermore, they had used dexmedetomidine infusion 0.5 mcg/kg bolus over 10 min started immediately after FIB, followed by 0.5 μg/kg/h all over the surgical duration. [9]…”

Section: Discussionmentioning

confidence: 99%

“…The minimal hemodynamic variations among FIB group which recorded in the current study were similar to the finding or Parate et al , in their case report although the patient aged 70 years with recent myocardial infarction and dexmedetomidine was infused all over the surgical duration. [9] This is because of FIB rarely reaches the lumbar plexus and devoid of central sympathetic blockade. [23]…”

Section: Discussionmentioning

confidence: 99%

“…Up to best of our knowledge, only Ruzbarsky et al [8] and Parate et al [9] had used FIB on a limited number of cases as a primary anesthetic alternate to neuraxial anesthesia and general anesthesia (GA) for lower limb surgeries; although, it was accompanied with light-to-moderate sedation. Therefore, FIB needs more assessment as a sole anesthetic technique.…”

Section: Introductionmentioning

confidence: 99%

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Fascia iliaca block as an anesthetic technique for: Acute lower limb ischemia

et al. 2019

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Purpose:The purpose of this study is to evaluate the efficacy of preoperative fascia iliaca block (FIB) as a sole anesthetic technique in transfemoral thromboembolectomy of unilateral acute lower limb ischemia compared to unilateral spinal anesthesia (SA) as a primary outcome. Hemodynamic variation, postoperative pain score, and the first demand for analgesia with the total postoperative analgesic required in the 1st postoperative day were considered as the secondary outcome.Patients and Methods:This prospective randomized controlled study included two groups of patients aged between 40 and 70 years, who underwent transfemoral thrombectomy for acute unilateral lower limb ischemia. Patients in the spinal group (SA) (n = 56): underwent unilateral SA using 10 mg bupivacaine 0.5% and patients in the group FIB (n = 56): received FIB with 30 mL of 0.25% bupivacaine. Sensory block was evaluated over the incisional area with 3-point scale. If the sensory block did not reach zero grade after 30 min, the patient received general anesthesia.Results:The incidence of the successful block was 100% in the SA group compared to 80.35% in the FIB group. There was a significant decrease in recorded heart rate and mean blood pressure within the SA group at 3, 10, and 20 min and 3, 20, and 45 min, respectively. Values of visual analog scale decreased significantly in SA group compared to that of the FIB group immediately and 1 h postoperative. However, the time for the first postoperative analgesic requirement and morphine consumption was comparable between the groups.Conclusion:Preoperative FIB could be considered as a promising alternative anesthetic technique to SA with better hemodynamic parameters in patients undergoing transfemoral thrombectomy for acute lower limb ischemia. It could be also due to limited precautions considered the first choice over SA for patients on perioperative anticoagulants.

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“…Furthermore, they had used dexmedetomidine infusion 0.5 mcg/kg bolus over 10 min started immediately after FIB, followed by 0.5 μg/kg/h all over the surgical duration. [9]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fascia iliaca block as an anesthetic technique for: Acute lower limb ischemia

et al. 2019

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“…SFICB was performed with the patient in the supine position while the skin over the area of interest was disinfected. Using the Desmet approach, a high-frequency linear probe was placed at the level of the anterior superior iliac spine [ 7 ]. Moving the probe medially, the sartorius, internal oblique, fascia iliaca, and iliopsoas were identified.…”

Section: Case Presentationmentioning

confidence: 99%

“…The suprainguinal approach of fascia iliaca compartment block (SFICB) was first described in 2011 [ 5 ]. Like the classic infrainguinal (IFICB) approach, it reliably blocks the FN; however, it offers higher rates of LFCN and ON blockade [ 6 , 7 ]. Better analgesia is provided but at the expense of a more challenging and time-consuming technique.…”

Section: Introductionmentioning

confidence: 99%

Applying the Suprainguinal Approach of Fascia Iliaca Compartment Block for Surgical Anesthesia in a Patient Undergoing Emergency Femoral Thrombectomy: A Case Report

Soulioti,

Antonopoulos,

Manikis

et al. 2023

Cureus

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We present the first documented case of achieving surgical anesthesia for a vascular surgery using the suprainguinal approach of the fascia iliaca compartment block (SFICB), in a patient with severe comorbidities from the cardiovascular system. More specifically, a male elderly patient with a history of cardiac amyloidosis, severe aortic stenosis, and coronary artery disease, was in need of emergent thrombectomy due to acute lower limb ischemia. During the evaluation of this patient, general and neuraxial anesthesia were both considered. However, the former would expose him to the risk of myocardial ischemia and other complications due to cardiovascular instability caused by the general anesthetic agents while the latter was absolutely contraindicated due to recent clopidogrel use and the specific pathophysiology changes induced by cardiac amyloidosis. Thus, a peripheral nerve block was deemed to be the best option in this case. SFICB, despite being challenging, could offer adequate analgesic results so it was the anesthetic technique of choice. The surgery was completed and the patient recovered appropriately. The aim of this report is to discuss the specific anesthetic considerations of this case, highlight the ability of SFICB to achieve surgical anesthesia in vascular surgeries, and increase familiarity with the procedure.

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Anesthesiologist View on Endovascular Aortic Aneurysm Repair; A Single Center Retrospective Study

ERTAŞ

ÇAKMAK²,

AKDENİZ

et al. 2023

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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Amaç: Minimal invaziv endovasküler stent greftleme yöntemleri olan endovasküler aort onarımı (EVAR) ve torasik endovasküler aort onarımı (TEVAR), aort anevrizmalarının tedavisinde geleneksel ve invaziv açık cerrahiye alternatif olarak uygulanmaktadır. Bu çalışmanın amacı hastanemizde EVAR ve TEVAR uygulanan hastalarda uygulanan anestezi yöntemlerini değerlendirmektir. Yöntemler: 01.01.2015-31.05.2022 tarihleri arasında endovasküler aort onarımı yapılan 95 hastanın dosyaları geriye dönük olarak incelendi. Hastalara ilişkin tanımlayıcı verilerin yanı sıra ameliyat süresi, yoğun bakım ve hastanede kalış süresi gibi veriler toplanarak değerlendirildi. Bulgular: Endovasküler aortik greftlemenin 14 hastaya genel anestezi (GA) (Grup GA) altında, 67 hastaya sedo-analjezi (SA) (Grup SA) altında yapıldığı belirlendi. 75 hastaya EVAR, 6 hastaya TEVAR uygulandı. EVAR hastalarının 11'inin GA, 64'ünün SA ile tedavi edildiği görüldü. Hastaların yaş ortalaması 68.73±8.31 yıl olup, 75'i erkekti. Hasta komorbiditeleri göz önüne alındığında gruplar arasında anlamlı fark yoktu (p>0.05). Yoğun bakımda kalış süreleri hastanede kalış süreleri açısından değerlendirildiğinde gruplar arasında istatistiksel olarak anlamlı fark bulunmadı (p>0.05). Sonuç: Bu çalışmada kliniğimizde EVAR/TEVAR uygulanan hastalarda intraoperatif sıvı gereksinimi dışında anestezi yönteminin üstünlüğünü belirleyemedik.

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Fascia Iliaca block as the sole anesthesia technique in a patient with recent myocardial infarction for emergency femoral thrombectomy

Cited by 3 publications

References 8 publications

Fascia iliaca block as an anesthetic technique for: Acute lower limb ischemia

Fascia iliaca block as an anesthetic technique for: Acute lower limb ischemia

Applying the Suprainguinal Approach of Fascia Iliaca Compartment Block for Surgical Anesthesia in a Patient Undergoing Emergency Femoral Thrombectomy: A Case Report

Anesthesiologist View on Endovascular Aortic Aneurysm Repair; A Single Center Retrospective Study

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