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Background and Aims Patients with DiGeorge syndrome may present with a wide array of signs and comorbidities related to anesthetic complications (e.g. difficult intubation), such as cleft palate or ‘Byzantine arch’ palate, maxillary and mandibular hypoplasia, recurrent upper and lower respiratory infections, various cardiac comorbidities. As such, anesthetic management of these patients via peripheral nerve block (PNB) under procedural sedation may present a viable and safer alternative.Methods We present the case of a 4 year old boy with genetically confirmed DiGeorge syndrome, weighing 13 kg, scheduled for elective clubfoot surgery. On induction the patient received Midazolam, Fentanyl, Propofol, Ketamine. Sedation with spontaneous breathing was maintained via continuous Propofol, with oxygen support via nasal cannula. We performed an ultrasound-guided popliteal block and adductor canal block with combined 2 ml of 2% Lidocaine and 10 ml of 0,25% Levobupivacaine.Results Throughout the 90 minute surgery the patient maintained perfect haemodynamic and respiratory stability. After uneventful awakening he was referred back to the ward where NSAID were instituted q8h and he remained pain free.Abstract P112 Figure 1Patient with stigmata of DiGeorge syndromeAbstract P112 Figure 2Ultrasound image of popliteal block related anatomy before (up) and after (down) administration of local anesthetic around the sciatic nerveConclusions Peripheral nerve block techniques have previously been described as safe and effective in adults as well as children for foot surgery. Use of PNBs under procedural sedation has been demonstrated as especially beneficial in patients under elevated risk of general anesthesia and/or risk of difficult intubation. The combination of popliteal block and adductor canal block presents a viable technique for pediatric foot surgery. Care must be taken to assess the risk of regurgitation and aspiration, as well as not to overlook pneumatic cuff placement and position.