Compartment syndrome of the upper limbs after bee sting: Case report

Abstract

Introduction: The upper limb compartment syndrome is considered an emergency. It may cause necrosis and loss of functionality of the hand. The principal treatment is fasciotomies. However, there are therapeutic possibilities that may help or avoid surgery, provided there is always the option to do a fasciotomy when conservative treatment fails.
Objective: To assess the clinical response and treatment safety with stellate ganglion block and cervical epidural anesthesia in a patient with compartment syndrome of both upper limbs.
Methods and Materials: Descriptive longitudinal prospective study in a case report format, of a patient with compartment syndrome of both upper extremities that underwent a stellate ganglion block and cervical epidural anesthesia for treating her condition. The patient was followed for 7 days. The recovery of sensitivity and the mobility were assessed on both hands, in addition to pain intensity and bilateral distal cyanosis improvement.
Results: The patient evolved satisfactorily with evidence of recovery of sensitivity and mobility in both hands, adequate pain control and immediate and bilateral improved distal cyanosis.
Conclusions: Sympathetic block and epidural cervical analgesia are a treatment option for the comprehensive approach of the compartment syndrome, as long as the patient receives constant monitoring of any alarm signs and a surgeon is immediately available to do fas-ciotomies if the intervention therapy fails.