Apan A.Babadağ Y.Çetik Ö.2020-06-252020-06-25201113000578https://hdl.handle.net/20.500.12587/2164We aimed at presenting successful 3 in 1 femoral nerve block in a patient with hydrocephalus, spina bifida and sacral agenesis, who had femur fracture. A three years old girl has traumatic fracture on right femur. Clinical examination revealed sins for difficult airway including micrognathia and macroglossia. Giant hydrocephalus, spina bifida and sacral agenesis with motor paralysis on lower extremities were concomitant findings that might be problematic in performing general anesthesia or central nerve blocks. We therefore decided to perform 3 in 1 femoral nerve block under light sedation. Midazolam 0.05 mg kg-1 was administered via venous access and a total of 10 ml local anesthetic mixture including 7.5 ml 0.5% levobupivacaine in saline dilution was injected with increments after contractions from quadriceps muscle were elucidated. External fixation was successfully performed without complication and analgesic requirement. Vital signs were stable throughout the surgery and during the early postoperative period. Patient was pain free for six hours during the postoperative period. Peripheral nerve blocks, whenever possible are considered as efficient and safe alternative for anticipated difficult airway in both for surgery and postoperative analgesia.trinfo:eu-repo/semantics/closedAccessAnesthesia, regionalFemoral nerve blockHydrocephalusSacral agenesisArticle1931911932-s2.0-80054860623Q4