Abstract

VILLAR, Tania et al. Prolonged brachial plexopathy following interscalene block for shoulder arthroplasty. Rev. colomb. anestesiol. [online]. 2019, vol.47, n.1, pp.71-75. ISSN 0120-3347.  https://doi.org/10.1097/cj9.0000000000000086.

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.

Keywords : Brachial Plexus Neuropathies; Nerve Block; Arthroplasty; Analgesia; Ultrasonics.

        · abstract in Spanish     · text in English | Spanish     · English ( pdf ) | Spanish ( pdf )