{
  "abstract": "Background and Aims Patients with hematological malignancies are immunocompromised and susceptible to soft tissue and bone infections, which may require multiple surgical debridement procedures. Thrombocytopenia and anaemia associated with hematological diseases require special consideration in anaesthesia planning and management. Regional anaesthesia offers an alternative to general anaesthesia, especially in high-risk patients.Methods A 61-year-old male patient with chronic myelomonocytic leukemia, thrombocytopenia and osteomyelitis was referred to our institution for surgical management of a secerning fistula in the posterolateral right femur. The sequestrectomy with necrosectomy was performed under general anaesthesia with adjunct sciatic nerve block. The patient underwent seven subsequent necrectomies, two of which were in sciatic and lateral femoral cutaneous nerve block, while the remaining five were under general anesthesia, by different anaesthesiologists.Results Procedures done under regional anaesthesia were opioid-free, with postoperative pain scores 2/10 on the numerical rating scale, compared to 5–7/10 after general anaesthesia. Patient exhibited more stable intraoperative hemodynamics and required fewer postoperative analgesics when the necrosectomy was performed under peripheral nerve block.Abstract P153 Figure 1Necrosectomy, posterolateral right femurAbstract P153 Figure 2MRI, osteomyelitis in the distal third of the right femurConclusions Peripheral nerve blocks performed in an aseptic technique may present a safe and effective alternative to general anaesthesia in immunocompromised patients requiring repeated surgical debridement. Special consideration is required when planning anesthesia or analgesia involving deep peripheral nerve blocks in patients with moderate to severe thrombocytopenia.",
  "authors": [
    {
      "affiliations": [
        "Resident, Dpt of Anaesthesiology, Pain Management and Intensive Medicine, Županijska Bolnica Čakovec, Čakovec, Croatia"
      ],
      "name": "Filip Grabant"
    },
    {
      "affiliations": [
        "Resident, Dpt of Anaesthesiology, Pain Management and Intensive Medicine, OB Pula, Pula, Croatia"
      ],
      "name": "Tea Načinović"
    },
    {
      "affiliations": [
        "Resident, Dpt of Anaesthesiology, Pain Management and Intensive Medicine, Clinical Hospital Center Sestre Milosrdnice, Traumatology Clinic, Zagreb, Croatia"
      ],
      "name": "Matea Lončar"
    },
    {
      "affiliations": [
        "Anesthesist/Intensivist, Dpt of Anesthesiology, Pain Management and Intensive Medicine, Clinical Hospital Center Sestre milosrdnice, Traumatology Clinic, Zagreb, Croatia"
      ],
      "name": "Vedran Lokošek"
    },
    {
      "affiliations": [
        "Anesthesist/Intensivist, Dpt of Anesthesiology, Pain Management and Intensive Medicine, Clinical Hospital Center Sestre milosrdnice, Traumatology Clinic, Zagreb, Croatia"
      ],
      "name": "Mirela Dobrić"
    }
  ],
  "title": "P153 Combined sciatic and lateral femoral cutaneous nerve blocks for repeated necrosectomies in a patient with osteomyelitis and chronic myelomonocytic leukemia – a case report",
  "uid": "ea21450f-c928-5c34-9c2f-a73603c7e480"
}