PDF(Pubmed)
Abstract：
Severe sepsis, a syndrome characterized by systemic inflammation and acute organ dysfunction in response to infection, is a major healthcare problem affecting all age groups throughout the world. Sepsis-associated encephalopathy (SAE) is a common but poorly understood neurological complication of sepsis. It is characterized by diffuse brain dysfunction secondary to infection elsewhere in the body without overt central nervous system (CNS) infection. Such cases commonly present for emergency surgical management with inadequate fasting hours, limited time for preparation, and preoperative optimization. Regional blocks become the savior in such cases where both general and central neuraxial anesthesia become perilous. Here, we present a 70-year-old male, with a case of necrotizing fascitis of the left lower limb with septic encephalopathy, with compromised cardiac or respiratory function and deranged laboratory investigations. The patient was admitted for emergency lower limb debridement, and ultrasound-guided left lower limb popliteal sciatic nerve block along with an adductor canal block was chosen as the plan of anesthesia management.
摘要：
严重脓毒症,一种以全身性炎症和急性器官功能障碍为特征的综合征，是影响全世界所有年龄组的主要医疗保健问题。脓毒症相关脑病（SAE）是一种常见但鲜为人知的脓毒症神经系统并发症。它的特征是继发于身体其他部位感染的弥漫性脑功能障碍，没有明显的中枢神经系统（CNS）感染。这种情况通常出现在紧急手术治疗中，禁食时间不足，准备时间有限，和术前优化。在一般和中央神经轴麻醉都变得危险的情况下，区域阻滞成为救星。这里,我们介绍一个70岁的男性,一例左下肢坏死性筋膜炎伴脓毒性脑病，心脏或呼吸功能受损，实验室检查混乱。患者因下肢紧急清创入院,选择超声引导下左下肢坐骨神经阻滞和内收肌管阻滞作为麻醉管理方案。
