Brachial plexus block improved refractory pain due to intraoperative position-related nerve injury: a case report

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  • SUGIBE Sayaka
    Operating Rooms, Kyushu University Hospital
  • MAEDA Aiko
    Operating Rooms, Kyushu University Hospital
  • SAIGANO Chiaki
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital
  • NAKAYAMA Shouko
    Operating Rooms, Kyushu University Hospital
  • HIGASHI Midoriko
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine
  • YAMAURA Ken
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine

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Other Title
  • 手術体位が原因で生じた左腕神経叢損傷による疼痛に対して腕神経叢ブロックが奏効した1症例
  • 症例 手術体位が原因で生じた左腕神経叢損傷による疼痛に対して腕神経叢ブロックが奏効した1症例
  • ショウレイ シュジュツ タイイ ガ ゲンイン デ ショウジタ サワン シンケイソウソンショウ ニ ヨル トウツウ ニ タイシテ ウデ シンケイソウブロック ガ ソウコウ シタ 1 ショウレイ

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<p>Background: Peripheral nerve injury is a significant perioperative complication. We report a case of a patient with intraoperative position-related brachial plexus injury, whose symptoms were improved by brachial plexus block. Case: A 23-year-old man underwent thoracoscopic resection for an anterior mediastinal tumor. The surgery lasted 8 hours under the right prone position with his left arm fixed at the shoulder height, and his neck-slightly extended. Immediately after the surgery, the patient complained of severe pain, with paralysis and numbness of the left upper extremity. Magnetic resonance neurography revealed a swollen brachial plexus. He was referred to our pain clinic because his symptoms did not improve with conservative treatment. We decided to perform ultrasound-guided branchial plexus block (1％ mepivacaine＋dexamethasone [3.3 mg]) to control pain and inflammation. After five blocks, although numbness remained, his pain improved considerably. Conclusion: The brachial plexus block could ameliorate acute neuropathic pain with inflammation.</p>

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