{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T19:32:12Z","timestamp":1783971132214,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Key Clinical Message<\/jats:title><jats:sec><jats:label\/><jats:p>Appropriate anesthetic technique for fracture fixation in multiple myeloma is crucial in minimizing perioperative complications. The use of pericapsular nerve group block followed by spinal anesthesia for the operative management of pathological fracture in multiple myeloma patient along with proper pre\u2010 and postanesthetic care ensures better outcome for the patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Multiple myeloma is a malignant plasma cell disease that often presents with anemia, renal failure, hyperkalemia and osteolytic bone lesions. The advancements in drug therapy of multiple myeloma have prolonged the lifespan of the affected people, resulting in a rise in cases of surgical management of fractures in such patients. Anesthetic management, despite being of utmost importance in minimizing perioperative complications in such patients, has not been widely studied, especially in this part of the world. Hence, we report a case of 64\u2009years diabetic, HbSAg positive male with hypothyroidism and a known case of multiple myeloma since the last 6\u2009years, under medication for his comorbidities who suffered acetabular fracture. In this case report, the use of pericapsular nerve group block followed by spinal anesthesia for the operative management of the fracture has been discussed along with several pre\u2010 and postanesthetic considerations. With appropriate anesthetic techniques and proper pre\u2010 and postanesthetic care, better outcomes can be guaranteed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.9374","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T09:33:56Z","timestamp":1724924036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pericapsular nerve group block followed by regional anesthesia for pathological fracture fixation in a multiple myeloma patient"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8344-3469","authenticated-orcid":false,"given":"Aayusha","family":"Suwal","sequence":"first","affiliation":[{"name":"Kathmandu Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nischal","family":"Subedi","sequence":"additional","affiliation":[{"name":"Kathmandu Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nischal","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Kathmandu Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ujma","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Kathmandu Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0025-6196(12)60015-9"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.4065\/78.1.21"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70442-5"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2005.01.008"},{"issue":"11","key":"e_1_2_12_6_1","first-page":"583","article-title":"Peripheral nerve blocks for lower limb surgery\u2014a choice anaesthetic technique for patients with a recent myocardial infarction?","volume":"43","author":"Chia N","year":"2002","journal-title":"Singapore Med J"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_450_20"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.bja.a013468"},{"key":"e_1_2_12_9_1","volume-title":"Morgan and Mikhail's Clinical Anesthesiology","author":"Butterworth JF","year":"2013"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-010-1399-7"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029245"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2005.01.013"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.117176"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2151458516658330"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-018-00631-y"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1998.tb05084.x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/7452716"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.33706\/jemcr.609134"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.5505\/ejm.2016.09719"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.9374","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T11:22:52Z","timestamp":1734002572000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.9374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":18,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1002\/ccr3.9374"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.9374","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,29]]},"assertion":[{"value":"2024-04-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e9374"}}