{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T19:56:10Z","timestamp":1781207770449,"version":"3.54.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,11]]},"DOI":"10.7759\/cureus.110679","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T18:59:01Z","timestamp":1781204341000},"source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-Guided Peripheral Nerve Block as the Sole Anesthetic for Above-Knee Amputation in a Patient With Severe Cardiopulmonary Comorbidities"],"prefix":"10.7759","author":[{"given":"Dilan","family":"Shah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nakosi","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bright","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Yoder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Pellegrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharvil","family":"Sharvil Sheth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.5074","article-title":"Factors associated with unplanned reoperation after above-knee amputation","volume":"154","author":"Edwards JB","year":"2019","unstructured":"Edwards JB, Wooster MD, Tran T, et al.. Factors associated with unplanned reoperation after above-knee amputation. JAMA Surg. 2019, 154:461-2. 10.1001\/jamasurg.2018.5074","journal-title":"JAMA Surg"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.02.016","article-title":"Global vascular guidelines on the management of chronic limb-threatening ischemia","volume":"69","author":"Conte MS","year":"2019","unstructured":"Conte MS, Bradbury AW, Kolh P, et al.. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg. 2019, 69:3S-125S.e40. 10.1016\/j.jvs.2019.02.016","journal-title":"J Vasc Surg"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000006813","article-title":"Turning tides. Evolving comorbidity profiles, demographic shift, and the unexpected rise of major lower extremity amputations","volume":"282","author":"Kougias P","year":"2025","unstructured":"Kougias P, Sharath SE, Ferguson C, et al.. Turning tides. Evolving comorbidity profiles, demographic shift, and the unexpected rise of major lower extremity amputations. Ann Surg. 2025, 282:429-38. 10.1097\/SLA.0000000000006813","journal-title":"Ann Surg"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2017.10.014","article-title":"Perioperative outcomes after regional versus general anesthesia for above the knee amputations","volume":"48","author":"Pisansky AJ","year":"2018","unstructured":"Pisansky AJ, Brovman EY, Kuo C, Kaye AD, Urman RD. Perioperative outcomes after regional versus general anesthesia for above the knee amputations. Ann Vasc Surg. 2018, 48:53-66. 10.1016\/j.avsg.2017.10.014","journal-title":"Ann Vasc Surg"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12186081","article-title":"Limb salvage and survival in chronic limb-threatening ischemia: the need for a fast-track team-based approach","volume":"12","author":"Ventoruzzo G","year":"2023","unstructured":"Ventoruzzo G, Mazzitelli G, Ruzzi U, Liistro F, Scatena A, Martelli E. Limb salvage and survival in chronic limb-threatening ischemia: the need for a fast-track team-based approach. J Clin Med. 2023, 12:10.3390\/jcm12186081","journal-title":"J Clin Med"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001024","article-title":"Diagnosis and management of patients with myocardial injury after noncardiac surgery: a scientific statement from the American Heart Association","volume":"144","author":"Ruetzler K","year":"2021","unstructured":"Ruetzler K, Smilowitz NR, Berger JS, et al.. Diagnosis and management of patients with myocardial injury after noncardiac surgery: a scientific statement from the American Heart Association. Circulation. 2021, 144:e287-305. 10.1161\/CIR.0000000000001024","journal-title":"Circulation"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2023.111106","article-title":"Perioperative strategies to reduce risk of myocardial injury after non-cardiac surgery (MINS): a narrative review","volume":"87","author":"Bello C","year":"2023","unstructured":"Bello C, R\u00f6ssler J, Shehata P, Smilowitz NR, Ruetzler K. Perioperative strategies to reduce risk of myocardial injury after non-cardiac surgery (MINS): a narrative review. J Clin Anesth. 2023, 87:111106. 10.1016\/j.jclinane.2023.111106","journal-title":"J Clin Anesth"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1502824","article-title":"Cardiac complications in patients undergoing major noncardiac surgery","volume":"373","author":"Devereaux PJ","year":"2015","unstructured":"Devereaux PJ, Sessler DI. Cardiac complications in patients undergoing major noncardiac surgery. N Engl J Med. 2015, 373:2258-69. 10.1056\/NEJMra1502824","journal-title":"N Engl J Med"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.2147\/LRA.S240753","article-title":"Control of spinal anesthesia-induced hypotension in adults","volume":"13","author":"Ferr\u00e9 F","year":"2020","unstructured":"Ferr\u00e9 F, Martin C, Bosch L, Kurrek M, Lairez O, Minville V. Control of spinal anesthesia-induced hypotension in adults. Local Reg Anesth. 2020, 13:39-46. 10.2147\/LRA.S240753","journal-title":"Local Reg Anesth"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.25364","article-title":"Regional technique provides complete surgical anesthesia for above-the-knee amputation: a viable alternative to general endotracheal anesthesia in a time of COVID-19","volume":"14","author":"Kujak MK","year":"2022","unstructured":"Kujak MK, Pomerantz LH, Petrovic M. Regional technique provides complete surgical anesthesia for above-the-knee amputation: a viable alternative to general endotracheal anesthesia in a time of COVID-19. Cureus. 2022, 14:e25364. 10.7759\/cureus.25364","journal-title":"Cureus"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.rapm.2004.10.002","article-title":"Lower-extremity peripheral nerve blockade: essentials of our current understanding","volume":"30","author":"Enneking FK","year":"2005","unstructured":"Enneking FK, Chan V, Greger J, Hadzi\u0107 A, Lang SA, Horlocker TT. Lower-extremity peripheral nerve blockade: essentials of our current understanding. Reg Anesth Pain Med. 2005, 30:4-35. 10.1016\/j.rapm.2004.10.002","journal-title":"Reg Anesth Pain Med"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/7023750","article-title":"Ultrasound-guided obturator nerve block: a focused review on anatomy and updated techniques","volume":"2017","author":"Yoshida T","year":"2017","unstructured":"Yoshida T, Nakamoto T, Kamibayashi T. Ultrasound-guided obturator nerve block: a focused review on anatomy and updated techniques. Biomed Res Int. 2017, 2017:7023750. 10.1155\/2017\/7023750","journal-title":"Biomed Res Int"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_346_17","article-title":"Peripheral nerve blocks for above knee amputation in high-risk patients","volume":"34","author":"Chandran R","year":"2018","unstructured":"Chandran R, Beh ZY, Tsai FC, Kuruppu SD, Lim JY. Peripheral nerve blocks for above knee amputation in high-risk patients. J Anaesthesiol Clin Pharmacol. 2018, 34:458-64. 10.4103\/joacp.JOACP_346_17","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000009374","article-title":"A case report: the use of ultrasound guided peripheral nerve block during above knee amputation in a severely cardiovascular compromised patient who required continuous anticoagulation","volume":"97","author":"Karm MH","year":"2018","unstructured":"Karm MH, Lee S, Yoon SH, Lee S, Koh W. A case report: the use of ultrasound guided peripheral nerve block during above knee amputation in a severely cardiovascular compromised patient who required continuous anticoagulation. Medicine (Baltimore). 2018, 97:e9374. 10.1097\/MD.0000000000009374","journal-title":"Medicine (Baltimore)"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.10.005","article-title":"A systematic review and meta-analysis of general versus regional anesthesia for lower extremity amputation","volume":"77","author":"Mufarrih SH","year":"2023","unstructured":"Mufarrih SH, Qureshi NQ, Yunus RA, et al.. A systematic review and meta-analysis of general versus regional anesthesia for lower extremity amputation. J Vasc Surg. 2023, 77:1542-52. 10.1016\/j.jvs.2022.10.005","journal-title":"J Vasc Surg"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2008.01859.x","article-title":"The successful use of peripheral nerve blocks for femoral amputation","volume":"53","author":"Bech B","year":"2009","unstructured":"Bech B, Melchiors J, B\u00f8rglum J, Jensen K. The successful use of peripheral nerve blocks for femoral amputation. Acta Anaesthesiol Scand. 2009, 53:257-60. 10.1111\/j.1399-6576.2008.01859.x","journal-title":"Acta Anaesthesiol Scand"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.79875","article-title":"Ropivacaine: a review of its pharmacology and clinical use","volume":"55","author":"Kuthiala G","year":"2011","unstructured":"Kuthiala G, Chaudhary G. Ropivacaine: a review of its pharmacology and clinical use. Indian J Anaesth. 2011, 55:104-10. 10.4103\/0019-5049.79875","journal-title":"Indian J Anaesth"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1053\/rapm.2003.50047","article-title":"Lipid reversal of bupivacaine toxicity: has the silver bullet been identified?","volume":"28","author":"Groban L","year":"2003","unstructured":"Groban L, Butterworth J. Lipid reversal of bupivacaine toxicity: has the silver bullet been identified?. Reg Anesth Pain Med. 2003, 28:167-9. 10.1053\/rapm.2003.50047","journal-title":"Reg Anesth Pain Med"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.4103\/IJCIIS.IJCIIS_60_17","article-title":"Ultrasound-guided peripheral nerve blocks in high-risk patients, requiring lower limb (above and below knee) amputation","volume":"8","author":"Shamim F","year":"2018","unstructured":"Shamim F, Hameed M, Siddiqui N, Abbasi S. Ultrasound-guided peripheral nerve blocks in high-risk patients, requiring lower limb (above and below knee) amputation. Int J Crit Illn Inj Sci. 2018, 8:100-3. 10.4103\/IJCIIS.IJCIIS_60_17","journal-title":"Int J Crit Illn Inj Sci"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/494607-ultrasound-guided-peripheral-nerve-block-as-the-sole-anesthetic-for-above-knee-amputation-in-a-patient-with-severe-cardiopulmonary-comorbidities","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T18:59:02Z","timestamp":1781204342000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/494607-ultrasound-guided-peripheral-nerve-block-as-the-sole-anesthetic-for-above-knee-amputation-in-a-patient-with-severe-cardiopulmonary-comorbidities"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":19,"URL":"https:\/\/doi.org\/10.7759\/cureus.110679","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,11]]}}}