Femoral and sciatic nerve block with 0.25% bupivacaine for surgical management of diabetic foot syndrome: an anesthetic technique for high-risk patients with diabetic nephropathy

J Clin Anesth. 2010 Aug;22(5):363-6. doi: 10.1016/j.jclinane.2009.04.009.

Abstract

A case series of patients with diabetic nephropathy, who underwent lower limb debridement or amputation below the knee during successful combined sciatic and femoral nerve block with bupivacaine 0.25%, is presented. Because impaired nerve conduction in diabetes mellitus results in lower local anesthetic agent requirement, a dose-sparing, minimal effective concentration for surgical anesthesia for peripheral nerve blockade may be more favorable for patients with diabetes and chronic renal disease.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthetics, Local / administration & dosage*
  • Bupivacaine / administration & dosage*
  • Diabetic Foot / surgery*
  • Diabetic Nephropathies / complications
  • Dose-Response Relationship, Drug
  • Female
  • Femoral Nerve
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Sciatic Nerve

Substances

  • Anesthetics, Local
  • Bupivacaine