Skip to main content

Advertisement

Log in

Saphenous and sciatic nerve block to treat acute lower limb ischemic pain in the emergency department

  • Published:
Journal of Ultrasound Aims and scope Submit manuscript

Abstract

Acute limb ischemia (ALI) presents with significant pain that is often refractory to opioid pain management or is present in patients with relative contraindications to opioids. Here we present a case of ALI successfully managed with regional anesthesia using sciatic and saphenous nerve blocks. To our knowledge, this is the first case report of regional anesthesia for ALI performed in the Emergency Department (ED) by Emergency Medicine physicians.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Dowell D, Haegerich TM, Chou R (2016) CDC guideline for prescribing opioids for chronic pain-United States, 2016. JAMA 315(15):1624–1645

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Herzig SJ, Mosher HJ, Calcaterra SL, Jena AB, Nuckols TK (2018) Improving the safety of opioid use for acute noncancer pain in hospitalized adults: a consensus statement From the Society of Hospital Medicine. J Hosp Med 4:263–271

    Article  Google Scholar 

  3. Gedikoglu M, Eker HE (2019) Ultrasound-guided popliteal sciatic nerve block: an effective alternative technique to control ischaemic severe rest pain during endovascular treatment of critical limb ischaemia. Pol J Radiol 84:e537–e541

    Article  PubMed Central  PubMed  Google Scholar 

  4. Tureli D, Deniz S, Unlukaplan A, Oguzkurt L (2018) Ultrasound-guided popliteal sciatic block provides adequate analgesia during urgent endovascular treatment of critical limb ischemia with resting pain. Cardiovasc Intervent Radiol 41:43–48

    Article  PubMed  Google Scholar 

  5. Marcus AJ, Lotzof K, Kamath BSK et al (2006) A new approach: regional nerve blockade for angioplasty of the lower limb. Cardiovasc Intervent Radiol 39:235–240

    Article  Google Scholar 

  6. Kucera TJ, Boezaart AP (2014) Regional anesthesia does not consistently block ischemic pain: two further cases and a review of the literature. Pain Med 15:316–319

    Article  PubMed  Google Scholar 

  7. Bunting LV, Calvello EJB (2021) Ultrasound guided nerve blocks. Sonoguide ultrasound guide for emergency physicians. https://www.acep.org/sonoguide/popliteal_nerve_block.html. Accessed 15 Feb 2021

  8. Croft PE, Mackenzie D (2020) How to perform an adductor canal nerve block. ACEPNow. Published August 21, 2020. https://www.acepnow.com/article/how-to-perform-an-adductor-canal-nerve-block/?singlepage=1. Accessed 15 Feb 2021

  9. Hopkins PM (2015) Does regional anaesthesia improve outcome? Br J Anaesth 115(Suppl 2):ii26–ii33

    Article  PubMed  Google Scholar 

  10. Macfarlane AJR, Vlassakov K, Elkassabany N (2019) Regional anesthesia for vascular surgery: does the anesthetic choice influence outcome? Curr Opin Anaesthesiol 32(5):690–696

    Article  PubMed  Google Scholar 

  11. Sgroi MD, McFarland G, Mell MW (2019) Utilization of regional versus general anesthesia and its impact on lower extremity bypass outcomes. J Vasc Surg 69(6):1874–1879

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Donald Byars.

Ethics declarations

Conflict of interest

GR, KF, MN, MJ, DB report no conflict of interest.

Ethical approval

Case Report deemed not human subjects research by IRB.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ransford, G., Feyzeau, K., Noble, M. et al. Saphenous and sciatic nerve block to treat acute lower limb ischemic pain in the emergency department. J Ultrasound 25, 979–981 (2022). https://doi.org/10.1007/s40477-021-00629-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40477-021-00629-0

Keywords

Navigation