Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient
The number of obese patients has increased dramatically worldwide. Morbid obesity is associated with an increased incidence of medical comorbidities and restricts the application choices in anesthesiology. We report a successfully performed combined ultrasound-guided blockade of the femoral, tibial,...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2014/896914 |
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| author | Alper Kilicaslan Ahmet Topal Atilla Erol Hale Borazan Onur Bilge Seref Otelcioglu |
| author_facet | Alper Kilicaslan Ahmet Topal Atilla Erol Hale Borazan Onur Bilge Seref Otelcioglu |
| author_sort | Alper Kilicaslan |
| collection | DOAJ |
| description | The number of obese patients has increased dramatically worldwide. Morbid obesity is associated with an increased incidence of medical comorbidities and restricts the application choices in anesthesiology. We report a successfully performed combined ultrasound-guided blockade of the femoral, tibial, and common peroneal nerve in a superobese patient. We present a case report of a 31-year-old, ASA-PS II, super obese man (190 kg, 180 cm, BMI: 58 kg/m2) admitted to the emergency department with a type II segmental tibia shaft fracture and ankle dislocation after a vehicle accident. After two failed spinal anesthesia attempts, we decided to apply a femoral block combined with a sciatic block. Femoral blocks were successfully performed with US guided in-plane technique. Separate blocks of the tibial and common peroneal nerves were planned after the sciatic nerve could not be located due to the thick subcutaneous tissue. We performed a tibial nerve block at 2 cm above the popliteal crease and common peroneal nerve at the level of the fibular head with US guided in-plane technique. The blocks were successful and no block-related complications were noted. Ultrasound guidance allows new approaches for multiple peripheral nerve blocks with low local anesthetic doses in obese patients. |
| format | Article |
| id | doaj-art-ef6cb029d28f4f42b9d60125c2a3dd99 |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-ef6cb029d28f4f42b9d60125c2a3dd992025-02-03T01:20:29ZengWileyCase Reports in Anesthesiology2090-63822090-63902014-01-01201410.1155/2014/896914896914Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese PatientAlper Kilicaslan0Ahmet Topal1Atilla Erol2Hale Borazan3Onur Bilge4Seref Otelcioglu5Department of Anaesthesiology, Meram Medical Faculty, Necmettin Erbakan University, 42080 Konya, TurkeyDepartment of Anaesthesiology, Meram Medical Faculty, Necmettin Erbakan University, 42080 Konya, TurkeyDepartment of Anaesthesiology, Meram Medical Faculty, Necmettin Erbakan University, 42080 Konya, TurkeyDepartment of Anaesthesiology, Meram Medical Faculty, Necmettin Erbakan University, 42080 Konya, TurkeyDepartment of Orthopaedic Surgery, Meram Medical Faculty, Necmettin Erbakan University, 42080 Konya, TurkeyDepartment of Anaesthesiology, Meram Medical Faculty, Necmettin Erbakan University, 42080 Konya, TurkeyThe number of obese patients has increased dramatically worldwide. Morbid obesity is associated with an increased incidence of medical comorbidities and restricts the application choices in anesthesiology. We report a successfully performed combined ultrasound-guided blockade of the femoral, tibial, and common peroneal nerve in a superobese patient. We present a case report of a 31-year-old, ASA-PS II, super obese man (190 kg, 180 cm, BMI: 58 kg/m2) admitted to the emergency department with a type II segmental tibia shaft fracture and ankle dislocation after a vehicle accident. After two failed spinal anesthesia attempts, we decided to apply a femoral block combined with a sciatic block. Femoral blocks were successfully performed with US guided in-plane technique. Separate blocks of the tibial and common peroneal nerves were planned after the sciatic nerve could not be located due to the thick subcutaneous tissue. We performed a tibial nerve block at 2 cm above the popliteal crease and common peroneal nerve at the level of the fibular head with US guided in-plane technique. The blocks were successful and no block-related complications were noted. Ultrasound guidance allows new approaches for multiple peripheral nerve blocks with low local anesthetic doses in obese patients.http://dx.doi.org/10.1155/2014/896914 |
| spellingShingle | Alper Kilicaslan Ahmet Topal Atilla Erol Hale Borazan Onur Bilge Seref Otelcioglu Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient Case Reports in Anesthesiology |
| title | Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient |
| title_full | Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient |
| title_fullStr | Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient |
| title_full_unstemmed | Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient |
| title_short | Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient |
| title_sort | ultrasound guided multiple peripheral nerve blocks in a superobese patient |
| url | http://dx.doi.org/10.1155/2014/896914 |
| work_keys_str_mv | AT alperkilicaslan ultrasoundguidedmultipleperipheralnerveblocksinasuperobesepatient AT ahmettopal ultrasoundguidedmultipleperipheralnerveblocksinasuperobesepatient AT atillaerol ultrasoundguidedmultipleperipheralnerveblocksinasuperobesepatient AT haleborazan ultrasoundguidedmultipleperipheralnerveblocksinasuperobesepatient AT onurbilge ultrasoundguidedmultipleperipheralnerveblocksinasuperobesepatient AT serefotelcioglu ultrasoundguidedmultipleperipheralnerveblocksinasuperobesepatient |