{
  "abstract": "Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionApplication for ESRA Abstract PrizesBackground and Aims 73-year-old female patient underwent total knee arthroplasty under regional anesthesia. A combination of peripheral nerve blocks was performed using ultrasound guidance and nerve stimulator to ensure accurate localization. The femoral, sciatic, lateral femoral cutaneous (LFCN) and obturator nerves were selectively blocked providing effective intraoperative anesthesia and postoperative analgesia.Methods Preoperatively femoral and sciatic nerves were each injected with 12 mL of 0,5% levobupivacaine combined with 4 mg of dexamethasone, respectively. Additional blocks of LFCN using 4 mL of 0,25% levobupivacaine and obturator nerve using 8 mL of 0,25% levobupivacaine were performed. The patient was sedated with 25 mg ketamine, 5 mcg sufentanyl, 2 mg midazolam, and TCI of propofol at an effective plasma concentration of 0,6 mcg/mL. Supplemental oxygen was delivered via face mask at 6 L/min. The patient was hemodynamically and respiratory stable throughout the procedure.Results Following surgery the patient was transmitted to the ward. No additional analgesia was required in the first 24 hours postoperatively. The effect of the peripheral nerve block lasted approximately 25 hours. At 25 hours postoperatively, the patient complained of pain score of 2–3 out of 10 and received 100 mg ketoprofen. The operated leg was placed in a continuous passive motion device (Kinetec). Upon later mobilization she reported pain 2 out of 10, while at rest she reported no pain.Conclusions This case demonstrates that multimodal peripheral nerve blocks combined with light sedation can provide effective anesthesia and prolonged postoperative analgesia in total knee arthroplasty. This approach minimizes opioid requirements, supports early mobilization and enhances patient comfort and recovery.",
  "authors": [
    {
      "affiliations": [
        "Department for Anesthesiology, Reanimatology and Intensive Care, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia"
      ],
      "name": "Vedran Lokošek"
    },
    {
      "affiliations": [
        "Department for Anesthesiology, Reanimatology and Intensive Care, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia"
      ],
      "name": "Katarina Matic"
    },
    {
      "affiliations": [
        "Department for Anesthesiology, Reanimatology and Intensive Care, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia"
      ],
      "name": "Tea Stipetic"
    },
    {
      "affiliations": [
        "Department for Anesthesiology, Reanimatology and Intensive Care, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia"
      ],
      "name": "Borna Trogrlic"
    }
  ],
  "title": "P311 Ultrasound and neurostimulator guided multimodal peripheral nerve blocks for total knee arthroplasty – case report",
  "uid": "11135eb8-9b78-56e6-9d16-9f01e748069e"
}