Local and Regional Anesthesia (Aug 2019)
Long-term placement of continuous popliteal nerve block catheter for management of a wounded patient in a combat field environment: a case report
Abstract
Costantino Fontana,1 Monica Rocco,2 Luigi Vetrugno,3 Elena Bignami41Anesthesia and Intensive Care Unit, Sapienza University of Rome, Rome, Italy; 2Intensive Care Unit and Anesthesia, Ospedale S. Andrea Rome, Rome, Italy; 3Anesthesia and Intensive Care Clinic, University-Hospital of Udine, Udine, Italy; 4Intensive Care Unit and Anestehsia, Università degli Studi di Parma, Parma, ItalyCorrespondence: Costantino FontanaAnesthesia and Intensive Care Unit, Sapienza University of Rome, Policlinico Militare di Roma, Piazza Celimontana n. 50, Roma 00184, ItalyEmail [email protected]: Continuous peripheral nerve block is a relevant part of multimodal treatment of postoperative pain. In this context the continuous popliteal nerve block is described as an option for postoperative pain management for surgical procedures on the leg, and particularly on the ankle and foot. We applied continuous popliteal nerve block for different types of anesthesia and postoperative pain management via the same catheter. No clear evidence of this specific use has been described in the literature. A 38 year-old patient wounded in combat with a displaced fracture of left tibia and extensive loss of substance needed orthopedic surgeries as well as several reconstructive procedures. A continuous popliteal nerve block was applied via ultrasound-guided catheter for anesthesia at different times, and postoperative pain control for all surgical procedures. The continuous popliteal nerve block and its long-term positioning, of non-common evidence in literature, was utilized to treat a poly-traumatized patient, thereby avoiding repeated general anesthesia and opioid use and their adverse effects. This technique, within a complicated combat field environment, was demonstrated to be clinically effective with high patient satisfaction.Keywords: regional anesthesia, continuous nerve block, continuous popliteal nerve block, postoperative pain management
