A preliminary report on the use of peripheral nerve blocks for lower limb amputations.
OBJECTIVE
To determine whether there are any advantages of using peripheral nerve blocks as an anaesthetic technique for patients undergoing lower limb amputations.


METHODS
Ten cases that had emergency surgery at the Korle Bu Teaching Hospital were reviewed. Indices looked at were the effectiveness of the nerve block, cardiovascular stability during surgery and the duration of postoperative analgesia provided by the block.


RESULTS
9 out of 10 cases had an above knee amputation (AKA) and 1 had a below knee amputation (BKA). 7 of the 10 cases were diabetics. A sciatic nerve block (SNB) combined with either a 3-in-1 block or a psoas compartment lumbar plexus block (LPB) was given to patients undergoing an AKA. A sciatic nerve block combined with a femoral nerve block was given to the patient undergoing a BKA. In 7 cases, anaesthesia provided by the block was good and in 3 cases it was fair. The patients were cardiovascularly stable during surgery. Postoperative pain relief provided by the blocks ranged from 5 hours to 30 hours.


CONCLUSIONS
Using peripheral nerve blocks for lower limb amputations is an effective technique of anaesthesia, providing cardiovascular stability as well as good postoperative analgesia.
Baddoo
Hk
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Department of Anaesthesia, University of Ghana Medical School, Accra.