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Ankle Surgery in a Patient with Acute Subdural Hematoma Under Combined Lumbar Plexus and Proximal Sciatic Nerve Block – A Case Report

Authors Acharya U, Lamsal R

Received 27 January 2020

Accepted for publication 4 April 2020

Published 15 April 2020 Volume 2020:13 Pages 29—32

DOI https://doi.org/10.2147/LRA.S247413

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Stefan Wirz


Utsav Acharya, Ritesh Lamsal

Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal

Correspondence: Utsav Acharya
Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu 44600, Nepal
Tel +977 9843613683
Fax +977 14473059
Email utsav.ach@gmail.com

Abstract: Acute subdural hematoma (aSDH) is commonly encountered in the emergency department in patients with traumatic injuries. If the hematoma is small, non-expanding and asymptomatic, it is managed conservatively. However, other injuries sustained during trauma may warrant surgical intervention, during which anesthetic management becomes challenging. There have been reports of rebleeding in patients with aSDH after undergoing surgery under either general or spinal anesthesia. Here we present a case where ankle surgery for tri-malleolar fracture was successfully performed in a patient with traumatic aSDH under combined lumbar plexus and proximal (para-sacral) sciatic nerve block.

Keywords: intracranial hemorrhage, regional anesthesia, traumatic brain injury, ultrasound

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