Delayed Neurological Recovery After Ultrasound-Guided Brachial Plexus Block: A Case Report

• Published in: Local and regional anesthesia Vol. 13; pp. 33 - 35
• Main Authors: Shrestha, Ninadini, Karki, Bipin, Koirala, Megha, Acharya, Santosh, Shrestha, Pramesh Sunder, Acharya, Subhash Prasad
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2020; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Anesthesia; Brachial plexus; Bupivacaine; Case Report; Case reports; complication; Injuries; Internal fixation; Magnetic resonance imaging; nerve conduction test; neurology; neuropathy; Neurotoxicity; Peripheral neuropathy; Polyneuropathies; Postoperative period; Time; Trauma; Ultrasonic imaging; Nepal; neuropathy; complication; nerve conduction test; neurology
• ISSN: 1178-7112; 1178-7112
• DOI: 10.2147/LRA.S250989

Brachial plexus blocks are frequently practiced and safe mode of anaesthsia. Although minor complications may occur, major complications are a rarity. However, we report a rare case of prolonged supraclavicular brachial plexus block which required almost 4 months to recover without a perceivable cause.
A 22-year-old gentleman posted for open reduction and internal fixation of both forearm bones was administered an ultrasound-guided supraclavicular brachial plexus block. The intra-operative period was uneventful. However, the block persisted for a very prolonged period of time. All perceivable causes were ruled out. A total of 19 weeks was required for the entire block to regress with no residual neurological deficits thereafter.
Although peripheral neuropathies are known complications of peripheral nerve blocks, such a prolonged brachial plexus block is a rare event. The only plausible cause for the patient's condition could have been the prolonged drug effect; however, it has been rarely documented.