Case report of anesthesia for free fibula flap reconstruction in Ewing sarcoma: Safety and efficacy of continuous popliteal sciatic nerve block and very low doses of intravenous heparin

Alessandra Di Palma; Federica Grassi; Lea Pia Cantatore; Francesca Tortora; Francesca Grussu; Mario Zama; Sergio Giuseppe Picardo

doi:10.1002/ccr3.5745

Case report of anesthesia for free fibula flap reconstruction in Ewing sarcoma: Safety and efficacy of continuous popliteal sciatic nerve block and very low doses of intravenous heparin

Clin Case Rep. 2022 Jun 3;10(6):e05745. doi: 10.1002/ccr3.5745. eCollection 2022 Jun.

Authors

Alessandra Di Palma¹, Federica Grassi¹, Lea Pia Cantatore², Francesca Tortora¹, Francesca Grussu³, Mario Zama³, Sergio Giuseppe Picardo¹

Affiliations

¹ Anesthesia and Intensive Care Department Ospedale Pediatrico Bambino Gesù Roma Italy.
² Anesthesia and Intensive Care Department Ospedali Riuniti di Foggia Roma Italy.
³ Plastic Surgery and Maxillofacial Surgery Department of Ospedale Pediatrico Bambino Gesù Roma Italy.

Abstract

A child with a maxillary Ewing sarcoma was operated for tumor asportation and reconstruction with free fibula flap. Adequate anticoagulation was achieved with lower doses of heparin and monitored with multiple ACT values. We used NIRS monitoring to avoid hypoperfusion. Post-operative pain relief was guarantited by local anestethic continous infusion.

Keywords: activated clotting time; continuous popliteal sciatic nerve block; ewing sarcoma; free fibula flap.

Publication types

Case Reports