Ultrasound-Guided Peripheral Nerve Block as the Sole Anesthetic for Above-Knee Amputation in a Patient With Severe Cardiopulmonary Comorbidities.

Authors

Dilan Shah, Nakosi Stewart, Bright Kim, Matthew Yoder, Anna Ng-Pellegrino, Sharvil Sharvil Sheth

Published in

Cureus. Volume 18. Issue 6. Pages e110679. Epub Jun 11, 2026.

Abstract

Above-knee amputation (AKA) carries substantial perioperative risk in patients with advanced cardiopulmonary disease for whom general and neuraxial anesthesia are poorly tolerated. Data supporting peripheral nerve blocks (PNBs) as the primary intraoperative anesthetic remain limited. We present a 79-year-old male with extensive cardiopulmonary and metabolic comorbidities who underwent left AKA for chronic limb-threatening ischemia. Ultrasound-guided sciatic, femoral, obturator, and lateral femoral cutaneous nerve blocks using ropivacaine were performed as the sole anesthetic with intravenous midazolam, achieving complete anesthesia without hemodynamic compromise. The Visual Analog Scale score was 0 postoperatively. The technique was reproduced successfully for contralateral amputation, reinforcing the role of PNBs as a primary anesthetic strategy in high-risk patients.

PMID:
42437226
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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