Anesthetic management of a high-risk patient with complex medical conditions: A case report of multimodal analgesia and regional nerve blocks in urgent transfemoral amputation

Haitem YOUBI *, Zakaria SQUALLI, Khalid SQALLI HOUSSAINI, Brahim BECHRI, Ali DERKAOUI, Abdelkarim SHIMI and Mohammed KHATOUF

Anesthesiology And Intensive Care Department A1, Hassan II University Hospital, Fez, Morocco, Faculty of Medicine and Pharmacy Of Fez, Sidi Mohammed Benabdellah University, Fez, Morocco.
 
Case Study
World Journal of Advanced Research and Reviews, 2024, 22(02), 430–435
Article DOI: 10.30574/wjarr.2024.22.2.1237
 
Publication history: 
Received on 12 March 2024; revised on 20 April 2024; accepted on 22 April 2024
 
Abstract: 
This case article presents the anesthetic management of a patient with complex medical conditions and surgical requirements. The patient had secondary hyperparathyroidism due to chronic renal failure, resulting in hypocalcemia. The patient required a transfemoral amputation due to progressive bacterial infection and global foot gangrene. The urgency of the operation prevented preoperative preparation and necessitated careful consideration of the patient's cardiovascular and respiratory challenges. Due to the patient's facial deformity and limited neck mobility, general anesthesia was not feasible. Instead, a multimodal analgesia approach was adopted, utilizing regional nerve blocks targeting various nerves involved in lower limb innervation. This approach, combined with sedation, provided effective surgical anesthesia.
 
Keywords: 
High-Risk; Anesthetic Management; Regional Nerve Blocks; Amputation; Hyperparathyroidism.
 
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