# A Case Report of an Ultrasound-Guided Popliteal Sciatic Nerve Block: An Asset for Emergency Lower Limb Debridement in a High-Risk Patient

## TL;DR

This case report describes using ultrasound-guided nerve blocks for emergency surgery in a high-risk patient with severe infection and neurological complications.

## Contribution

The paper highlights the use of regional anesthesia as a safe alternative in patients with sepsis-associated encephalopathy.

## Key findings

- Ultrasound-guided popliteal sciatic nerve block was successfully used for emergency lower limb debridement.
- Regional anesthesia was chosen due to the patient's compromised cardiac and respiratory function.
- The approach avoided risks associated with general or central neuraxial anesthesia.

## Abstract

Severe sepsis, a syndrome characterized by systemic inflammation and acute organ dysfunction in response to infection, is a major healthcare problem affecting all age groups throughout the world. Sepsis-associated encephalopathy (SAE) is a common but poorly understood neurological complication of sepsis. It is characterized by diffuse brain dysfunction secondary to infection elsewhere in the body without overt central nervous system (CNS) infection. Such cases commonly present for emergency surgical management with inadequate fasting hours, limited time for preparation, and preoperative optimization. Regional blocks become the savior in such cases where both general and central neuraxial anesthesia become perilous. Here, we present a 70-year-old male, with a case of necrotizing fascitis of the left lower limb with septic encephalopathy, with compromised cardiac or respiratory function and deranged laboratory investigations. The patient was admitted for emergency lower limb debridement, and ultrasound-guided left lower limb popliteal sciatic nerve block along with an adductor canal block was chosen as the plan of anesthesia management.