Ultrasound guided poplitial sciatic nerve block in a patient with ihd

Introduction: Anaesthetic management in a patient with co existing cardiac disease is always a challenge especially when it is an emergency. Peripheral nerve blocks are always safer than centrineuraxial anaesthesia or general anaesthesia in a patient suffering from ischemic heart disease (IHD), use of USG makes block more specific. Case report: A 63 yrs old male suffered from crush injury of left foot was posted for emergency debridement and external fixation. History ECG and ECHO suggested old IHD. Patient was suffering from crush injury with fractures of talus and calcanium so the patient had to be operated Popletial sciatic nerve block with supplementation of saphenous nerve block was planned. Patient was made to lie prone, ultrasound probe was placed in popletial fossa in the crease. popletial artery was identified probe was moved 6 cm proximal to crease where sciatic nerve divided into tibial and common peronial Intraoperatively patient was haemodynamically stable without any variation in BP or pulse. Patient did not have pain for 24hours post operatively. Conclusion: Regional nerve blocks are safe in patients with IHD with good postoperative analgesia using ultrasound guidance reduces the risk of inadverant vascular injury , the procedural time and procedure-related pain and increases patient satisfaction compared to nerve stimulation while providing similar block characteristics.