Continuous Suprainguinal Fascia Iliaca Block for Postoperative Analgesia in a Patient with Alkaptonuria: A Case Report

Alkaptonuria is a rare inherited genetic disorder of tyrosine metabolism characterized by homogentisic aciduria, ochronosis, and arthritis. Ochronosis leads to bluish-blackish pigmentation of connective tissues with multiple system involvement (musculoskeletal, ocular, renal, respiratory, airway, cardiovascular, genitourinary, and cutaneous). We report the perioperative anesthetic management of a 71-year-old patient with alkaptonuria and multiple comorbidities scheduled for a total hip replacement. He was a known case of alkaptonuria and hypertension, with a history of atrial fibrillation. This case highlights the anesthetic challenges posed by multisystem involvement, associated comorbidities, and multiple drug allergies, emphasizing the need for a carefully tailored and safe anaesthetic strategy.