title: [Ultrasound-guided peripheral nerve block for high-risk patients with arteriosclerosis obliterans in lower limb surgery--a report of nine cases].
abstract: Most patients with arteriosclerosis obliterans (ASO) have severe complications such as coronary artery disease, congestive heart failure and chronic kidney disease. They receive long-term antithrombotic therapy which is a contraindication to neuraxial anesthesia. In this retrospective study, we reviewed nine high-risk patients with ASO (revised cardiac risk index more than three) who underwent an urgent lower limb surgery under ultrasound-guided peripheral nerve block (PNB). In all cases, intraoperative hemodynamic changes remained minimized. In eight of the nine cases, analgesics are not required until 10 hours after the operation. No complication related to PNB occurred. Ultrasoundguided PNB for patients with ASO undergoing lower limb surgery can be a useful anesthetic technique, providing cardiovascular stability and good postoperative analgesia.
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medicine, Tokyo 113-8519.
authors.forename: Koji
authors.initials: K
authors.lastname: Kido
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Koshi
authors.initials: K
authors.lastname: Makita
mesh_terms: D000368:Aged; D001162:Arteriosclerosis Obliterans / Q000188:drug therapy / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D035002:Lower Extremity / Q000294:innervation* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D010525:Peripheral Nerves / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012306:Risk; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents