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International Journal of Contemporary Research in Multidisciplinary

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International Journal of Contemporary Research In Multidisciplinary, 2024;3(6):128-129

Ultrasound-Guided Peripheral Nerve Block for Tension Band Wiring of Patella in a High-Risk Patient with Coronary Artery Disease

Author Name: Karanvir Singh Sidhu;   Bikash Kumar N Oli;   Kirtika Yadav;   Harpreet Kaur;   Shirin Parveen;  

1. MBBS, Junior Resident, Department of Anaesthesiology, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India

2. MBBS, Junior Resident, Department of Anaesthesiology, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India

3. MD, Assistant Professor, Department of Anaesthesiology, King Georges Medical University, Lucknow, Uttar Pradesh, India

4. MD, Assistant Professor, Department of Anaesthesiology, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India

5. DNB, Associate Professor, Department of Anaesthesiology, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India

Abstract

This case report highlights the use of ultrasound-guided peripheral nerve block (PNB) as an anesthetic technique for a high-risk 75-year-old male patient with a history of coronary artery disease undergoing tension band wiring of the patella. The patient presented with a fracture following a fall and had multiple comorbidities, including diabetes, hypertension, and reduced cardiac function (EF 35%). A combination of sciatic, femoral, lateral femoral cutaneous, and obturator nerve blocks was administered using ultrasound guidance to ensure precise localization and minimize risks associated with central neuraxial anesthesia. The procedure resulted in effective regional anesthesia, perioperative hemodynamic stability, and successful surgical outcomes. This case underscores the efficacy and safety of ultrasound-guided PNB in managing lower extremity surgeries in critically ill and high-risk patients.

Keywords

Ultrasound, Patella, Coronary Artery Disease, non-cardiac surgery