Revision of loop colostomy under regional anaesthesia and sedation

Abstract

Patients presenting for emergency abdominal procedures often have medical issues that cause both generaanaesthesia and central neuraxial blockade to pose significant risks. Regional anaesthetic techniques are often used adjunctively for abdominal procedures under general anaesthesia, but there is limited published data on proceduredone under peripheral nerve or plexus blocks. We herein report the case of a patient with recent pulmonary embolism and supraventricular tachycardia who required colostomy refashioning. Ultrasonography-guided regional anaesthesia waadministered using a combination of ilioinguinal-iliohypogastric, rectus sheath and transversus abdominis plane blocksThis was supplemented with propofol and dexmedetomidine sedation as well as intermittent fentanyl and ketaminboluses to cover for visceral stimulation. We discuss the anatomical rationale for the choice of blocks and compare thanaesthetic conduct with similar cases that were previously reported.