Patients with perioperative myocardial infarction are prone to undergo myocardial infarction. Hence, general anesthesia is not preferred due to profound hypotension and myocardial depression. Alternatively, the use of peripheral nerve blocks for below knee amputation (BKA) have the advantage of cardiovascular stability, especially in a case of peri-operative myocardial infarction. Here, we report a 61 year old male patient, ASA Grade IV with a history of recent myocardial infarction, diabetes mellitus for 15 years. The patient developed right diabetic foot with septicemia, requiring right BKA. The surgery were successfully carried out under ultrasound-guided combined popliteal, fascia illiaca and adductor canal blocks.
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