Materials and Methods: 36 patients belonging to ASA grade 3 were administered combined femoral and sciatic block for knee surgery. In an attempt to find a more suitable anesthesia technique for these patients, we have, over the past one year,performed combined femoral and sciatic block in 36ASA grade 3 patients scheduled to undergo knee surgery. Introduction: ASA grade 3 patients undergoing knee surgery present with several risk factors for both general and neuraxial anaesthesia. The dilution of albumin attenuated acidosis.Ībsorption of normal saline during laser enucleation of prostate caused hyperchloremic metabolic acidosis and airway edema. Application of the simplified Stewart approach clearly suggested that hyperchloremia was the principal cause of metabolic acidosis. Further evaluation confirmed the absorption of a large amount of saline into the circulation via the perforated bladder. Oropharyngeal and neck edema was observed, and laboratory examination revealed considerable acidosis with hyperchloremia. Intraoperatively, abdominal distension prompted the attending anesthesiologist to consider the possibility of SGA malposition, and the trachea was intubated. However, saline absorption may cause hyperchloremic metabolic acidosis.Ī male in his late seventies underwent holmium laser enucleation of the prostate under a combination of subarachnoid block and general anesthesia. Recent technological advancements have enabled the use of electrolyte solutions such as saline or buffered electrolyte solution during transurethral resection or laser enucleation of the prostate.
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