en Clinical Medicine Clinical Medicine Case Series Case Series Background: High risk cases of leg amputation were one of major concerns in anesthesiologists.　<br> Cases: Sixteen cases with American Society of Anesthesiologists physical status (ASA-PS) 3 or 4 for leg amputation were reported.&nbsp;&nbsp;Fifteen patients were medicated with more than two anticoagulants and 11 patients had bleeding tendency.&nbsp;&nbsp;Thirteen patients received below knee amputation (BKA) and three patients received above knee amputation (AKA).&nbsp;&nbsp;Twelve patients received sciatic and femoral nerve blocks using ropivacaine and lidocaine then intravenous fentanyl and/or midazolam, and four received general anesthesia with inhalation anesthetics.&nbsp;&nbsp;Vasopressors were administered in 3/12 patients anesthetized by blocks and all patients by general anesthesia.&nbsp;&nbsp;Heart rate increased to more than 120 beats/min during surgery in all cases in general anesthesia.&nbsp;&nbsp;VAS scores in postoperative 12 hours after surgery was 0 to 3 in patients anesthetized with blocks and 4 to 7 in patients with general anesthesia.&nbsp;&nbsp;Phantom pain might be less in blocks.&nbsp;&nbsp;<br> Conclusions: Femoral and sciatic nerve blocks with small dose of fentanyl and/or midazolam seemed to be better than general anesthesia in terms of hemodynamics during surgery and postoperative analgesia. lower leg, amputation, femoral nerve block, sciatic nerve block, general anesthesia 0 0 http://ibbj.org/browse.php?a_code=A-10-353-1&slc_lang=en&sid=1 Tomoki Nishiyama nishit-tky@umin.ac.jp 10031947532846003723 10031947532846003723 Yes Maruyama Memorial General Hospital