Local and Regional Anesthesia (Apr 2020)
Delayed Neurological Recovery After Ultrasound-Guided Brachial Plexus Block: A Case Report
Abstract
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 [email protected]: 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
