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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
GEIER, Karl Otto. The lateral midfemoral approach to sciatic nerve block as an anesthetic option to trauma: case repor t. Rev. Bras. Anestesiol. [online]. 2006, vol.56, n.1, pp. 46-51. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942006000100006.
BACKGROUND AND OBJECTIVES: Both nervous plexus block and isolated peripheral nerve block are uncommon procedures for patients with lower limb trauma or full stomach, prevailing epidural and spinal blocks as the primary indication. This case report describes the choice of sciatic nerve block as the best indication for a patient with full stomach and severe foot trauma. CASE REPORT: Male patient, 50 years old, physical status ASA II, moderately obese (BMI = 29.8), hypertensive, bus driver for 29 years with decompressive lumbar laminectomy (L4-L5 e L5-S1) 10 years ago, under antidepressants, who suffered motorcycle accident soon after having eaten. Mallampati test was class III. After excluding several anesthetic techniques, sciatic nerve block was chosen as the best option. Anesthesia was induced with 10 mL of 2% lidocaine and 15 mL of 0.5% bupivacaine, both with epinephrine 1:200 000, resulting in more than 15 hours of analgesia. CONCLUSIONS: Lateral midfemoral sciatic nerve block as anesthetic option for foot trauma was based on pre-established criteria, such as the preference for regional anesthesia in patients with full stomach and candidates to urgency limb procedures, postural limitation of patients to perform some techniques, such as spinal procedures, anatomic understanding of somatic limb innervation and the mastering of alternative regional techniques.
Keywords : ANESTHETIC TECHNIQUES, Regional [sciatic nerve block]; SURGERY, Orthopedic [lower limb].