[Ultrasound-guided sciatic nerve block in the popliteal fossa for the postoperative pain control after Achilles' tendon repair].

To assess the usefulness of ultrasound-guided sciatic nerve block in the popliteal fossa in the postoperative pain management after Achilles' tendon repair, we compared 15 patients managed by general anesthesia and sciatic nerve block (Group B) with 17 patients managed by general anesthesia alone (Group G). The time required for the nerve block was about 20 minutes on the average, and the success rate was 100%. No significant complication associated with the nerve block was observed. Fentanyl dosing for the postoperative analgesia was significantly smaller in the Group B. Although the postoperative analgesic requirement was comparable, the time to the first postoperative analgesic administration was significantly longer in the Group B. This retrospective study suggests that ultrasound-guided sciatic nerve block in the popliteal fossa provides safe and effective postoperative pain relief after Achilles' tendon repair.

Iatrogenic right coronary artery occlusion during minimally invasive cardiac surgery-tricuspid annuloplasty-a case report.

Although rare, right coronary artery (RCA) injury is a serious complication of tricuspid annuloplasty (TAP) and warrants close attention. We report a case of ST elevation myocardial infarction secondary to iatrogenic RCA occlusion during minimally invasive cardiac surgery (MICS). Electrocardiography (ECG) revealed ST segment elevation in lead II. Transesophageal echocardiography (TEE) revealed inferior wall hypokinesis after cardiopulmonary bypass, and coronary angiography revealed peripheral RCA occlusion. Intraoperatively, we detected an atrioventricular groove deformity during the second surgical procedure. Wall motion and ECG abnormalities showed normalization after TAP was reestablished. Vigilant monitoring using TEE and ECG is important to detect intraoperative myocardial ischemia during MICS-TAP.