Document Detail

Brachial plexus block in a parturient.
MedLine Citation:
PMID:  24631059     Owner:  NLM     Status:  Publisher    
We report a novel circumstance of brachial plexus anesthesia in a parturient. A 25-year-old woman at 34weeks of gestation presented with a pathologic proximal right humerus fracture from an intramedullary mass. She was scheduled for tumor biopsy which was performed using a two-site ultrasound-guided brachial plexus block to maximize odds of complete anesthesia while minimizing the risk of phrenic nerve paresis. After a supraclavicular block with 0.5% ropivacaine 20mL, we translated our ultrasound probe cephalad, inferior to the root of C7 where the divisions of the superior trunk could be seen in a tightly compact arrangement. An additional injection of 0.5% ropivacaine 20mL was administered at this site, and the patient subsequently underwent successful biopsy without sedatives or analgesics, aside from local anesthetics. In the post-anesthesia care unit, she had normal respirations and oxygen saturations breathing room air, denied any shortness of breath or difficulty breathing, and was discharged shortly after her arrival. While we did not pursue radiologic examination to rule out hemidiaphragm paralysis, we assumed, as evidenced in a previous case report, that unlike most healthy patients, a parturient would demonstrate some clinical signs and/or symptoms of hemidiaphragm paralysis, given that the diaphragm is almost totally responsible for inspiration in the term parturient. This represents only the second brachial plexus block in a parturient reported in the literature; the first using ultrasound guidance and without respiratory embarrassment.
M Patzkowski; J Scheiner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-1-8
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  -     ISSN:  1532-3374     ISO Abbreviation:  Int J Obstet Anesth     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2014-3-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Published by Elsevier Ltd.
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