Anesth Pain Med.  2011 Jul;6(3):270-274.

Femoral and sciatic nerve blocks for total knee replacement in an obese patient with a previous history of failed endotracheal intubation: A case report

• Kim JH
• Roh WS
• Jung JY
• Song SY
• Kim JE
• Kim BJ

Abstract

Peripheral nerve block has frequently been used as an alternative to epidural analgesia for postoperative pain control in patients undergoing total knee replacement. However, there are few reports demonstrating that the combination of femoral and sciatic nerve blocks (FSNBs) can provide adequate analgesia and muscle relaxation during total knee replacement. We experienced a case of successful FSNBs for a total knee replacement in a 66 year-old female patient who had a previous cancelled surgery due to a failed tracheal intubation followed by a difficult mask ventilation for 50 minutes, 3 days before these blocks. FSNBs were performed with 50 ml of 1.5% mepivacaine because she had conditions precluding neuraxial blocks including a long distance from the skin to the epidural space related to a high body mass index and nonpalpable lumbar spinous processes. This case suggests that FSNBs can provide a good alternative anesthetic method for total knee replacement.

Keyword

Femoral nerve; Intubation; Nerve block; Sciatic nerve; Total knee replacement

MeSH Terms

Analgesia
Analgesia, Epidural
Arthroplasty, Replacement, Knee
Body Mass Index
Epidural Space
Female
Femoral Nerve
Humans
Intubation
Masks
Mepivacaine
Muscle Relaxation
Nerve Block
Pain, Postoperative
Peripheral Nerves
Sciatic Nerve
Skin
Ventilation
Mepivacaine