Peripheral nerve block combined with general anesthesia for lower extremity amputation in hemodialysis patients: case series

• DOI: 10.1186/s40981-018-0214-x
• Publication Date: 2018-10-25T17:19:31Z
• Authors: Hitomi Takemura; Daisuke Fujita; Megumi Matsuda; Kazuko Fujita; Masahiro Sakaguchi; Fumimasa Amaya
• Keywords: Pain medicine

Anesthetic management of lower extremity amputation in chronic hemodialysis (HD) patients can be challenging because their poor cardiovascular status. As previously reported, peripheral nerve block (PNB) may beneficial these complicated cases. We report the effects PNB combined with general anesthesia on hemodynamic stability HD undergoing elective amputation.We retrospectively analyzed 13 who underwent amputation. Patients received (GA group, n = 7) or 6), as decided by anesthesiologists. Mean blood pressure (MBP), systolic (SBP), lowest BP, heart rate (HR), loss, fluid and infusion volumes, doses vasopressors required were compared for assessment. The coefficient variation ([Formula: see text]) MBP (CVMBP) SBP (CVSBP) was calculated to compare stability. Intraoperative opioid use postoperative pain scores at rest using a numerical rating scale (NRS) days 0 1 also assessed 30-day mortality.CVMBP GA group significantly higher than that (0.15 ± 0.05 0.08 0.04, respectively, p 0.03). CVSBP (0.16 0.02 0.09 0.01, No significant differences other parameters observed. fentanyl 210.7 99.9 μg vs. 113.0 75.6 μg, 0.04). There no mortality between groups.Our results suggest contributes intraoperative through better control