ABSTRACT : The main aim of patients with diabetes and associated comorbidities undergoing surgery is to provide hemodynamic stability and lower the risk of complications associated with anaesthesia and surgery as general anaesthesia and central neuraxial blockade may impair hemodynamic stability. Therefore, in such patients regional nerve block proves to be a better alternative. We present a case of a 50 year old patient, known case of Diabetes Mellitus with Hypertension & Chronic Kidney Disease with Global hypokinesia of Left Ventricle with mild Mitral regurgitation with mild left ventricular dysfunction with ejection fraction of 40% with bilateral pleural effusion with underlying consolidation of lungs presented with chronic non-healing ulcer on dorsal aspect of right foot posted for disarticulation.

METHODS : Patient was premedicated with Inj. Ondansetron 4mg, Inj. Midazolam 1mg. A combined Sciatic & Femoral block was performed using a nerve stimulator after infiltrating local anaesthetic in lateral decubitus position with 40 ml of 0.5% Bupivacaine combined with 2% Lignocaine with adrenaline. Onset of analgesia occurred within 10-15 mins and motor blockade was confirmed by patient’s inability to move his toes. Oxygen supplemented with venti mask. The surgery lasted for 1 hour. Intra-op period was uneventful and pain relief lasted for 5 hours.

RESULTS : -

CONCLUSIONS : Sciatic Femoral block is preferred over other methods of anaesthesia as it preserves cardiopulmonary integrity, reduces the need of polypharmacy and the side effects associated with it.