Delayed Neurological Recovery After Ultrasound-Guided Brachial Plexus Block: A Case Report
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 ca...
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| Published in: | Local and regional anesthesia Vol. 13; pp. 33 - 35 |
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| Abstract | 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. |
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| AbstractList | Introduction: 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. Case Presentation: 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. Conclusion: 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. Keywords: complication, nerve conduction test, neurology, neuropathy Introduction: 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. Case Presentation: 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. Conclusion: 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. Case Presentation: 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. 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. Ninadini Shrestha, 1 Bipin Karki, 2 Megha Koirala, 1 Santosh Acharya, 3 Pramesh Sunder Shrestha, 1 Subhash Prasad Acharya 1 1Department of Anaesthesia, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal; 2Department of Critical Care Medicine, Om Hospital and Research Center Pvt. Ltd, Chabahil, Kathmandu, Nepal; 3Department of Critical Care Medicine, Hospital for Advanced Medicine and Surgery, Dhumbarahi, Kathmandu, NepalCorrespondence: Bipin KarkiDepartment of Critical Care Medicine, Om Hospital and Research Center Pvt. Ltd., GPO 13494, Chabahil, Kathmandu, NepalTel +977 9841701269Fax +977 14466128Email karki_bipin@yahoo.comIntroduction: Brachial plexus blocks arefrequently 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.Case Presentation: A 22-year-old gentleman posted for open reduction and internal fixation of bothforearm 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.Conclusion: 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.Keywords: complication, nerve conduction test, neurology, neuropathy |
| Audience | Academic |
| Author | Acharya, Subhash Prasad Shrestha, Pramesh Sunder Shrestha, Ninadini Karki, Bipin Acharya, Santosh Koirala, Megha |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32425591$$D View this record in MEDLINE/PubMed |
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| Keywords | neuropathy complication nerve conduction test neurology |
| Language | English |
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| References | Sala-Blanch (ref6) 2009; 34 Raizada (ref8) 2002; 46 ref12 (ref2) 2017 Lenters (ref5) 2007; 16 ref4 Takeda (ref7) 2015; 65 Knight (ref9) 2015; 28 Choi (ref10) 2014; 112 Prtridge (ref11) 1991; 75 Brull (ref1) 2007; 104 Davis (ref3) 2009; 21 |
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| Snippet | Brachial plexus blocks are frequently practiced and safe mode of anaesthsia. Although minor complications may occur, major complications are a rarity.... Introduction: Brachial plexus blocks are frequently practiced and safe mode of anaesthsia. Although minor complications may occur, major complications are a... Case Presentation: A 22-year-old gentleman posted for open reduction and internal fixation of both forearm bones was administered an ultrasound-guided... Ninadini Shrestha, 1 Bipin Karki, 2 Megha Koirala, 1 Santosh Acharya, 3 Pramesh Sunder Shrestha, 1 Subhash Prasad Acharya 1 1Department of Anaesthesia,... |
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| SubjectTerms | 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 |
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| Title | Delayed Neurological Recovery After Ultrasound-Guided Brachial Plexus Block: A Case Report |
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