Combined femoral and sciatic nerve blocks for lower limb anaesthesia in anticoagulated patients with severe cardiac valvular lesions

Peripheral nerve block (PNB) in anticoagulated patients is controversial and guidelines are not defined. We report two patients with severe cardiac valvular lesions, who underwent emergency surgeries for lower limb. Both the patients were on anticoagulants, warfarin and heparin in one and aspirin and clopidogrel in the other, with abnormal coagulation profile in the former. Combined femoral and sciatic nerve blocks were used as a sole anaesthetic technique. Postoperatively, the patients were evaluated for bleeding complications at the injection site using high-frequency ultrasound probe. Both had uneventful surgery and recovery. A close postoperative monitoring following PNBs in anticoagulated patients is necessary.