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Delayed Neurological Recovery After Ultrasound-Guided Brachial Plexus Block: A Case Report

Authors Shrestha N, Karki B, Koirala M, Acharya S, Shrestha PS, Acharya SP

Received 23 February 2020

Accepted for publication 15 April 2020

Published 23 April 2020 Volume 2020:13 Pages 33—35

DOI https://doi.org/10.2147/LRA.S250989

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Stefan Wirz


Ninadini Shrestha, 1 Bipin Karki, 2 Megha Koirala, 1 Santosh Acharya, 3 Pramesh Sunder Shrestha, 1 Subhash Prasad Acharya 1

1Department of Anaesthesia, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal; 2Department of Critical Care Medicine, Om Hospital and Research Center Pvt. Ltd, Chabahil, Kathmandu, Nepal; 3Department of Critical Care Medicine, Hospital for Advanced Medicine and Surgery, Dhumbarahi, Kathmandu, Nepal

Correspondence: Bipin Karki
Department of Critical Care Medicine, Om Hospital and Research Center Pvt. Ltd., GPO 13494, Chabahil, Kathmandu, Nepal
Tel +977 9841701269
Fax +977 14466128
Email karki_bipin@yahoo.com

Introduction: Brachial plexus blocks are frequently practiced and safe mode of anaesthsia. Although minor complications may occur, major complications are a rarity. However, we report a rare case of prolonged supraclavicular brachial plexus block which required almost 4 months to recover without a perceivable cause.
Case Presentation: A 22-year-old gentleman posted for open reduction and internal fixation of both forearm bones was administered an ultrasound-guided supraclavicular brachial plexus block. The intra-operative period was uneventful. However, the block persisted for a very prolonged period of time. All perceivable causes were ruled out. A total of 19 weeks was required for the entire block to regress with no residual neurological deficits thereafter.
Conclusion: Although peripheral neuropathies are known complications of peripheral nerve blocks, such a prolonged brachial plexus block is a rare event. The only plausible cause for the patient’s condition could have been the prolonged drug effect; however, it has been rarely documented.

Keywords: complication, nerve conduction test, neurology, neuropathy

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