{
  "abstract": "Background and Aims This is a case report of a 79 year old male, ASA 4 patient with infected and occluded fem distal graft needing emergency surgery. He was septic with psudomonas infected groin wound, drowsy with renal impairment and other comorbidities. The neuraxial block like combined spinal epidural was risky due to his coagulation and septic status. Post operative pain management was also very challenging in his case.Methods The planned surgery was graft removal and ligation of artery and possibly Above Knee amputation. Renal impairment and need for prolonged surgical time needed prolonged anesthesia and analgesia as well. The patient was consented for an ultrasound guided psoas compartment block explaining the risks and benefits. It was performed safely using 30 ml 0.25% levobupivacaine with adrenaline and a psoas compartment catheter was inserted. Perioperatively patient had a sciatic nerve block as well to provide omplete analgesia of the lower limb. A gentle GA was given to keep the patient comfortable on the table for the prolonged surgery.Results The procedure was done successfully without any complications and the pain score in recovery was 0/10. The infusion was continued as continuous with intermittent boluses to provide analgesia post operatively. The patient did not require any opioids during the stay and the catheter was removed after 5 days.Abstract P207 Figure 1Psoas compartment blockConclusions This case shows the importance of meticulous anaesthetic management perioperatively with comprehensive, multidisciplinary approach, integrating advanced regional anesthesia techniques, is crucial for ensuring patient safety and improving outcomes in such challenging scenarios.",
  "authors": [
    {
      "affiliations": [
        "Consultant, Anaesthesia and Pain Management, East Kent Hospitals University NHS Trust, Canterbury, UK"
      ],
      "name": "Velliyottillom Parameswaran"
    },
    {
      "affiliations": [
        "Consultant, Department of Anaesthesia and Pain Management, Kent and Canterbury Hospital, Canterbury, UK, Rochester, UK"
      ],
      "name": "Athmaja Thottungal"
    }
  ],
  "title": "P207 Ultrasound guided psoas compartment block and catheter for removal of infected fem-distal graft in a complex ASA 4 vascular patient- case report",
  "uid": "51d78fff-8fe6-5a8b-889f-619b6c57a0b9"
}