Özlem ÖZKALAYCI, Seçil ÇETİN, Muhammet AHMET KARAKAYA, Aytekin ÜNLÜKAPLAN, Agah Rauf İŞGÜZAR, Yavuz GÜRKAN

Morbid Obez Bir Hastada Diyabetik Ayak Cerrahisi için Ultrason Rehberliğinde Popliteal ve Safen Sinir Bloğu Uygulaması

Bu olgu sunumunda, diyabetik ayak cerrahisi geçiren anestezi açısından yüksek riskli hastada ultrason rehberliğinde periferik sinir bloğu uygulama deneyimimizi paylaştık. Hipertansiyon, diyabetes mellitus, koroner arter hastalığı olan morbid obez hastada popliteal ve safen sinir bloğu uygulandı. Bloklar ultrason rehberliğinde 100 mm blok iğnesi ile yapıldı. Popliteal blok supin pozisyonda diz fleksiyonda 15 mL % 0.5 bupivakain ve 15 mL %2 lidokain ile, safen sinir bloğu ise 5 mL % 0.5 bupivakain ve 5 mL %2 lidokain verilerek yapıldı. Dolaşım ve solunum sistemleri etki- lenmeden cerrahi sorunsuz olarak tamamlandı. Periferik sinir blokları yüksek riskli hastalarda güvenli alternatif anestezi yöntemi olarak akılda tutulmalıdır.

Ultrasound Guided Popliteal and Saphenous Nerve Blocks for Diabetic Foot Surgery in a Morbidly Obese Patient

In this case report, we shared our experience of ultrasound- guided peripheral nerve block appli- cation in a high risk patient for anesthesia undergoing diabetic foot surgery. In a patient with hypertension, diabetes mellitus, coronary artery disease popliteal and saphenous nerve blocks were performed. The blocks were performed with a 100 mm block needle, guided by ultrasound. The popliteal block was performed with 15 mL of 2% bupivacaine and 15 mL of 0.5% lidocaine with the knee in flexion and for saphenous nerve block 5 mL of 0.5% bupivacaine and 5 mL 2% lidocaine was administered. Surgery was completed without comprimising the circulatory and respiratory systems. Peripheral nerve blocks should be kept in mind as a safe alternative method of anesthesia in high risk patients.

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