Are gadgets saviours in salvaging sick cases – Ultrasound for both nerve blocks and vascular access in a case of septic shock

Ultrasound -the lifensaver


Diabetes mellitus and diabetic foot syndrome present to us with varying degrees of sepsis. We present a 52-year-old male with chronic diabetes with fore foot sepsis in shock. His blood sugar was controlled with insulin and the other parameters were normal. The blood pressure was around 90/ 50 mm Hg with noradrenaline support of 0.5 mic/kg/minute. We secured a right internal jugular venous access with ultrasound (USG). The volume status as assessed by USG of the IVC was satisfactory. We administered popliteal sciatic nerve block along with saphenous nerve block visualising the nerves with USG. The amputation of forefoot went on for one hour where the haemodynamics remained stable at 100/ 70 mmHg. After the surgery was over, the patient was shifted to sick cubicle and in another six hours, the inotrope support was weaned off. The control of sugars was continuously monitored. Any other form of neuraxial block could have been detrimental to him in the presence of hemodynamic imbalance. Such precise deposition of local anaesthetics in the sciatic nerve is very difficult without the use of USG.  We conclude that advanced gadgets may bring back hope in salvaging sick patients.

Keywords: diabetes, sepsis, nerve block, vascular access, ultrasound

Author Biographies

Madhula.P, Mahatma gandhi medical college and research institute, 

Post graduate student, 

Mahatma gandhi medical college and research institute, 

Sri Balaji Vidyapeeth 

Puducherry - India 


postgraduate student,

Mahatma Gandhi Medical college and research institute, 

Sri Balaji Vidyapeeth - Puducherry


S parthasarathy, Associate professor Mahatma gandhi medical college and research institute puducherry India


Department of anesthesiology 

Mahatma Gandhi medical college and research institute 

puducherry, South India 


1.Zhang P et al. Global epidemiology of diabetic foot ulceration: A systematic review and meta-analysis. Ann Med. 2017;49(2):106-16.
2.S. Parthasarathy, Ramsesh Manohar. Combined Mandibular Nerve Block and Superficial Cervical Plexus Block for Parotid Gland Surgery.BJPMR.2017: 2;(1) 394-396. DOI:
3.Kumar T S, Indu K, Parthasarathy S. Successful management of above knee amputation with combined and modified nerve blocks. Anesth Essays Res 2017;11:520-1
4.Pourmand A, Pyle M, Yamane D, Sumon K, Frasure SE. The utility of point-of-care ultrasound in the assessment of volume status in acute and critically ill patients. World J Emerg Med. 2019;10(4):232-238. doi:10.5847/wjem.j.1920-8642.2019.04.007.
5.Parthasarathy S, Indu K, Excision of right nasolabial cyst under intra oral infra orbital nerve block – a case report and a short review. Indian J Clin Anaesth 2017;4(1):147-149
6.B K Arjun, R S Prijith Ultrasound-guided popliteal sciatic and adductor canal block for below-knee surgeries in high-risk patients. Indian J Anaesth. 2019 Aug; 63(8): 635–639
7.Bond D M, Champion L K, Nolan R. Real-Time Ultrasound Imaging Aids Jugular Venipuncture. Anesth Analg. 1989;68:700–701.
8.D. Eissa, E. G. Carton, D. J. Buggy, Anaesthetic management of patients with severe sepsis, BJA: British Journal of Anaesthesia, (2010): 105; 6, 734–743,
6 Views | Downloads
How to Cite
Madhula.P, Priya.H, and S. parthasarathy. “Are Gadgets Saviours in Salvaging Sick Cases – Ultrasound for Both Nerve Blocks and Vascular Access in a Case of Septic Shock : Ultrasound -the Lifensaver ”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 14, no. 2, Jan. 2021,
Case Study(s)