Spinal anesthesia and infraclavicular brachial plexus block for upper extremity reconstruction requiring grafting

Abstract

Combined use of upper limb blocks in the same surgery with lower limb central blocks is rarely performed due to the risk of systemic toxicity of local anesthetics. Therefore, general anesthesia is generally preferred in such surgeries. However, the use of ultrasound provides reliable anesthetic accumulation around the nerves, thereby reducing the need for local anesthetics, furthermore local anesthetic is used in spinal anesthesia compared to epidural anesthesia is much less. In this case report, a 32 year old male patient with ASA-1 score who underwent upper extremity reconstruction with a skin graft to be taken from the side thigh under spinal anesthesia and ultrasound-guided infraclavicular brachial plexus block. Both the peripheral block and the central block were successful and no complications related to the blocks were observed. We think that combining spinal anesthesia with ultrasound-guided infraclavicular brachial plexus block is a clinically useful and safe technique and is an alternative method of anesthesia for reconstruction of the upper limb requiring skin grafts.

Keywords: Analgesia; Nerve block; Pain; Reconstuction; Ultrasonography

Citation: Turan M, Kaya S, Tas S, Bas A, Gulec H, Sahap M, Erkilic E, But A. Spinal anesthesia and infraclavicular brachial plexus block for upper extremity reconstruction requiring grafting. Anaesth. Pain Intensive Care 2020;24(4):460-462.

Received: 20 May 2020, Reviewed: 31 My 2020, Revised: 29 June 2020, Accepted: 29 June 2020