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Submitted: 04 December 2014 Modified: 24 September 2015
HERDIN Record #: R07-CVHRDC-1412040710178

Instant relief by the three-one technique: a case report.

Rhea Roma F. Miguel, MD

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      This is the case report of a 71 years old male retired teacher who is a chronic smoker, chronic alcoholic beverage drinker, chronic hypertensive, post-stroke, epileptic, poorly-controlled diabetic patient with hypoalbuminemia, hypoprothrombinemia, pneumonia, and peripheral vascular disease. 

      The patient's condition warrants the needs for the anesthesia technique that renders him safe given medical co-existing disease. As the patient was scheduled for an emergency below the knee amputation with possible above knee amputation, he was offered regional anesthesia by the peripheral nerve blockade using the three-in-one technique, and the sciatic nerve block techniques. He was made to understand the benefits and risk involved in the procedure. An alternative balanced general anesthesia was also offered as alternative treatment option should the peripheral nerve blockade fail. This was accepted by the patients.

     The patients underwent the procedure in the morning, after having been adequately prepared and medically cleared for surgery. He was cooperative during the entire procedure. His stay at the recovery room was unremarkable. He was transported back to his room without untoward events. Post-operatively, he was render pain-free. He was discharged improved on the fifth post-operative day.

Publication Type
Research Project



   1. The discuss the case of a seventy-one years old male with right foot swelling and multiple co-existing diseases.

   2. To discuss the regional anesthesia by the peripheral nerve blockade using the three-in one technique, and the trans-table approach for the sciatic nerve block technique.

   3. To discuss the importance of a balanced general anesthesia as an ideal alternative management option in the patient with right foot swelling and multiple co-existing disease.


LocationLocation CodeAvailable FormatAvailability
Vicente Sotto Memorial Medical Center Fulltext Print Format
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