Prolonged brachial plexopathy following interscalene block for shoulder arthroplasty

  • Tania Villar a. Department of Anaesthesia and Critical Care, Hospital del Mar, Barcelona, Spain.
  • Susana Pacreu a. Department of Anaesthesia and Critical Care, Hospital del Mar, Barcelona, Spain.
  • Eva Chavero a. Department of Anaesthesia and Critical Care, Hospital del Mar, Barcelona, Spain.
  • Carles Torrens a. Department of Traumatology and Orthopaedics, Hospital del Mar, Barcelona, Spain.
  • Antonio Montes a. Department of Anaesthesia and Critical Care, Hospital del Mar, Barcelona, Spain.
Keywords: Brachial Plexus Neuropathies, Nerve Block, Arthroplasty, Analgesia, Ultrasonics

Abstract

Interscalene block (ISB) is the brachial plexus approach most frequently used in shoulder surgery, providing better postoperative analgesia and reducing the need for rescue morphine compared to general anesthesia. While it is considered a safe block, it has been associated with a relatively high rate of complications, the most serious of which are postoperative neurologic symptoms, such as paresthesia, dysesthesia, and reduced sensitivity. We present the case of a patient with prolonged neurological deficit lasting 4 months following nerve stimulation-guided ISB. Due to the multifactorial nature of postoperative neurological lesions, it can be difficult to determine their etiology. In our case, the brachial plexopathy was probably due to the administration of local anesthetic through the perineurium. We discuss possible causes and argue for the use of ultrasound associated with nerve stimulation when an ISB is performed in order to reduce the incidence of nerve puncture.

References

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How to Cite
1.
Villar T, Pacreu S, Chavero E, Torrens C, Montes A. Prolonged brachial plexopathy following interscalene block for shoulder arthroplasty. Colomb. J. Anesthesiol. [Internet]. 2019Jan.1 [cited 2022Aug.14];47(1):71-5. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/223

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Published
2019-01-01
How to Cite
1.
Villar T, Pacreu S, Chavero E, Torrens C, Montes A. Prolonged brachial plexopathy following interscalene block for shoulder arthroplasty. Colomb. J. Anesthesiol. [Internet]. 2019Jan.1 [cited 2022Aug.14];47(1):71-5. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/223
Section
Case Report / Case Series

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