We report a patient with severe pulmonary arterial hypertension (PAH) undergoing\ntibio-talo-calcaneal fusion due to Charcot joint. Despite the advancement\nin the management of PAH, the risks of anesthesia, surgery, and\npostoperative morbidity and mortality still remain high. A 46-year-old female\nwas presented with severe PAH and end stage renal disease requiring hemodialysis\nthree times a week. Ultrasound-guided sciatic, femoral, and obturator\nnerve blocks were performed with 0.5% levobupivacaine 15 ml, 10 ml, and 5\nml, respectively. All the blocks were successful, and the patient underwent\nuneventful anesthesia and surgery. In addition, the postoperative pain control\nlasted for 15 h and the patient was discharged on POD 5 without any complications.\nTherefore, ultrasound-guided sciatic, femoral, and obturator nerve\nblocks are valuable alternative to the general or neuraxial anesthesia in patients\nwith severe pulmonary hypertension.
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