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The practice of anesthesia can include the need to accommodate surgical interventions on multiple extremities in a single procedure. General anesthesia is usually preferred in such cases in order to prevent an overdose of local anesthetics. One of the major benefits of using ultrasonography to provide regional anesthesia is that it facilitates reducing the local anesthetic drug dose required to obtain a successful block. The use of multiple, ultrasound-guided extremity blocks can be a reasonable alternative approach to general anesthesia, especially in high-risk patients. This report describes the case of a patient with malignant melanoma of the left lateral forearm. Surgical resection of the lesion, dissection of the axillary sentinel lymph node, and grafting from the lateral left thigh were planned. As the surgical procedure involved more than one extremity, a combination of anesthetic blocks was applied using ultrasound guidance. The use of supraclavicular, intercostobrachial, and lateral femoral cutaneous blocks is explained in the context of the literature.

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Our performance of supraclavicular, intercostobrachial and lateral femoral cutaneous block in a patient with high risk undergoing malign melanoma surgery on the forearm