Bilateral Brachial Plexus Block Using Chloroprocaine For Surgery Of Bilateral Radial Fractures
Authors Mangla C, Kamath HS, Yarmush J
Received 31 July 2019
Accepted for publication 10 September 2019
Published 27 September 2019 Volume 2019:12 Pages 99—102
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Stefan Wirz
Chanchal Mangla, Hattiyangadi Sangeetha Kamath, Joel Yarmush
Department of Anesthesiology, New York Presbytarian Brooklyn Methodist Hospital, New York, NY, USA
Correspondence: Chanchal Mangla
Department of Anesthesiology, New York Presbyarian Brooklyn Methodist Hospital, 506 Sixth Street, Brooklyn, New York, NY, USA
Tel +1 718 780 3270
Abstract: We report a case of a 41-year-old male with anticipated difficult airway undergoing a repair of a bilateral radial fracture under bilateral sequential brachial plexus block. Anesthesiologists are reluctant to perform bilateral blocks because of the fear of complications like diaphragmatic paralysis, local anesthetic (LA) toxicity, and pneumothorax. We advise that with the correct application of LA pharmacokinetics, careful patient selection and usage of ultrasound, bilateral blocks can be done safely. We used chloroprocaine as an LA in one of the blocks to reduce the dose required for the more toxic LAs. chloroprocaine’s fast metabolism also helped us to prevent the overlapping of peak plasma concentration of different LAs. To our knowledge, this is the first reported case in the literature where chloroprocaine was used for bilateral brachial plexus block.
Keywords: brachial plexus block, local anesthetics (LA), chloroprocaine
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