Ultrasound-guided suprainguinal fascia iliaca block combined with a sacral plexus block for lower extremity surgery

Abstract

Rationale: The anesthetic management of patients with severe pulmonary hypertension is different from that of normal, healthy patients, and regional nerve blocks are commonly used for them. Due to the individual variability of the course, distribution, and branching of the nerves below the inguinal ligament, the supra-inguinal fascia iliaca (SIFI) block has a wider and more stable blocking area. In combination with the sacral plexus block, they can satisfy the needs of surgical anesthesia below the hip. Patient concerns: A 46-year-old man with tuberculosis, chronic obstructive pulmonary disease, pulmonary heart disease, World Health Organization (WHO) class III pulmonary hypertension and right heart dysfunction, and American Society of Anesthesiologists physical status class III needed fixation of an intramedullary nail in the left lower extremity. Additionally, he had broken his left lower limb after a recent fall. Both general anesthesia and epidural anesthesia were not appropriate. Diagnoses: The patient had a clear history of tuberculosis, computerized tomography scan displayed destructive pneumonophthisis. Furthermore, he had chronic obstructive pulmonary disease and pulmonary heart disease. Interventions: An ultrasound-guided SIFI combined with a sacral plexus block was successfully performed for surgical anesthesia and avoided all hemodynamic fluctuations. Outcomes: We successfully performed an ultrasound-guided SIFI combined with a sacral plexus block for surgical anesthesia and avoided all hemodynamic fluctuations. Lessons: Ultrasound-guided suprainguinal fascia iliaca block combined with a sacral plexus block can be suitable for anesthesia for patients with severe circulatory compromise.

Applicability and Effectiveness of Ultrasound Combined Nerve Stimulator-Guided Lumbosacral Plexus Block in Supine Versus Lateral Position During Surgeries for Lower Limb Fracture-A Prospective Randomized Controlled Trial

“…Despite this evidence, the selection of the area above the inguinal ligament and below the pelvic iliac fascia is considered a reliable approach. Therefore, an applicable method modi ed from FICB, termed as SIFI block, was developed to replace the conventional fascia iliaca block and femoral nerve block [19]. In their study, Zheng et al [11] used the SIFI compartment block in order to demonstrate that the diffusion of 30 ml local anesthetics could fully block the femoral nerve and lateral femoral cutaneous nerve, as well as provide a 56% block of the obturator nerve.…”

Applicability and effectiveness of ultrasound combined with nerve stimulator-guided lumbosacral plexus block in the supine versus lateral position during surgeries for lower limb fracture-a prospective randomized controlled trial

“…Despite this evidence, the selection of the area above the inguinal ligament and below the pelvic iliac fascia is considered a reliable approach. Therefore, an applicable method modified from FICB, termed SIFI block, was developed to replace the conventional fascia iliaca block and femoral nerve block [ 27 ]. Zheng et al [ 9 ] used the SIFI compartment block to demonstrate that the diffusion of 30 ml local anaesthetics could fully block the femoral nerve and lateral femoral cutaneous nerve, and provide a 56% block of the obturator nerve.…”

“…In a case report, ultrasound-guided SIFI combined with a sacral plexus block was found to be suitable for anaesthesia for patients with severe circulatory compromise and avoided all haemodynamic fluctuations [ 27 ]. In our study,intubation via laryngeal mask was performed 30 min following nerve block for patients in both groups, which shortened the onset time of the nerve block effects.…”