2014 Volume 21 Issue 2 Pages 97-101
We report a patient with intractable painful toe ulcer whose pain and wound healing were improved by continuous sciatic nerve block (CSNB). An 80-year-old man who was on anticoagulant therapy had gradually developed ulcer and pain in the toe during 2 months. We suspected that this condition was caused by vasospastic ischemia. Because caudal block provided temporary analgesia, we performed CSNB. We inserted a catheter on the right sciatic nerve and administered a continuous infusion of 0.2% levobupivacaine at a rate of 4 ml/h. Although pain disappeared after the block, a motor block on an ankle appeared. Therefore we gradually decreased the concentration of local anesthetic. When concentration was reduced to 0.03%, plantar flexion and dorsiflexion appeared, but no pain recurred. The ulcers turned to scabs, and the wound healing was good. CSNB may become one of the effective treatments for patients with painful ischemic ulcers of the leg.
