Stimulator-guided supraclavicular block as an anesthetic option for above-elbow amputation in an infant

Abstract

The supraclavicular block is effective in providing surgical anesthesia for upper limb surgery. The safety profile is improved with the use of a nerve stimulator to locate the brachial plexus. Above-elbow amputation in infants is commonly done under general anesthesia, however, the presence of certain comorbid conditions may increase the risk of mortality. We report the use of a nerve stimulator-guided supraclavicular block with sedation, to carry out transhumeral amputation for an 11-week-old female infant who had gangrene of her left forearm. The subclavian perivascular approach was used to perform the block. A mixture of 0.5% bupivacaine and 2% lidocaine in adrenaline was administered to achieve surgical anesthesia. The onset of the block was 5 min. A total of 2 mg of midazolam was used for sedation. The infant had a successful block. There was no block-related complication. We suggest that nerve stimulator-guided supraclavicular block in infants is feasible and safe.

Keywords

• amputation
• nerve stimulator
• supraclavicular block
• surgical anesthesia