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- Feb 20, 2008
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Open forum type discussion here. 71 year old cat, nice as can be with early ALS and no other comorbidities presents for ORIF of right ankle. His gait is unstable and he has speech and swallowing difficulty. Site of ankle fracture rules out ankle block. Pt does not want ET tube because of fear of exacerbating swallowing difficulty and family has heard that spinal anesthesia can worsen ALS. What would ya'll do in this situation?
We attempted to appease everyone by using a saphenous/popliteal block-which didn't set up quickly enough for the ortho guys and easily converted to propofol induction w/o NMB and sevo maintainence. No troubles at all. Anyone have lots of experience on these neuro disease types and thoughts on what to do different? Just thought this might be interesting for discussion. Coincidentally, the peripherial blocks were SWEET for post-op pain. Homeskillet was feeling fine.
~PoorInvestment~
We attempted to appease everyone by using a saphenous/popliteal block-which didn't set up quickly enough for the ortho guys and easily converted to propofol induction w/o NMB and sevo maintainence. No troubles at all. Anyone have lots of experience on these neuro disease types and thoughts on what to do different? Just thought this might be interesting for discussion. Coincidentally, the peripherial blocks were SWEET for post-op pain. Homeskillet was feeling fine.
~PoorInvestment~