A CLINICAL CASE REPORT: COSTOCLAVICULAR BRACHIAL PLEXUS BLOCK FOR DISTAL RADIUS FRACTURE FIXATION IN A PATIENT WITH SEVERE PULMONARY DISEASE

Xuan Hung Pham1, , Thi Nga Nguyen1
1 Trường Đại học Y Dược Hải Phòng

Main Article Content

Abstract

We present a clinical case of a 41-year-old female patient with a right distal radius fracture accompanied by complete left lung collapse, restrictive ventilatory disorder, and a history of treated tuberculosis. The patient was admitted to the hospital due to limited mobility of the right forearm following a motorcycle-to-motorcycle traffic accident, and was indicated for right distal radius fracture fixation. The patient received a single-shot costoclavicular brachial plexus block before the surgical fixation and did not require any additional opioids or other analgesics during or after surgery in the recovery room. This case demonstrates that the costoclavicular brachial plexus block is a safe and effective regional anaesthesia technique for upper limb surgery, particularly in patients with compromised pulmonary function.

Article Details

References

1. Albrecht E, Chin KJ. Advances in regional anaesthesia and acute pain management: A narrative review. Anaesthesia. 2020; 75(1):e101-e110. DOI: 10.1111/anae.14868.
2. ASRA Pain Medicine. How I do it: Costoclavicular brachial plexus block. Published November 1, 2021. Accessed May 15, 2024. https://www.asra.com/ news-publications/asra-newsletter/ newsletter-item/asra-news/2021/11/01/ how-i-do-it-costoclavicular-brachial-plexus-block.
3. Silva GR, Borges DG, Lopes IF, Ruzi RA, Costa PRR de M, Mandim BL da S. Ultrasound-guided costoclavicular block as an alternative for upper limb anesthesia in obese patients. Braz J Anesthesiol. 2019; 69:510-513. DOI: 10.1016/j.bjane.2019.09.003.
4. Neal JM, Barrington MJ, Fettiplace MR, et al. The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on local anesthetic systemic toxicity: Executive summary 2017. Reg Anesth Pain Med. 2018; 43:113-123. DOI: 10.1097/AAP.0000000000000720.
5. Reeves MT, O’Neil K, Slesinger TL. Costoclavicular brachial plexus block facilitates painless upper extremity reduction: A case report. Clin Pract Cases Emerg Med. 2023; 7:221-226. DOI: 10.5811/cpcem.59091.
6. Kewlani A, Bhatia N, Makkar JK, Kumar V. Median effective volume of 0.5% ropivacaine for ultrasound-guided costoclavicular block. Anesthesiology. 2021; 134:617-625. DOI: 10.1097/ ALN.0000000000003731.
7. Hipólito Labandeyra, Heredia C, Váldes-Vilches LF, et al. Clavipectoral fascia plane block in midshaft clavicle fractures: A cadaveric study. J Clin Anesth. 2024; 86:111469. DOI: 10.1016/j.jclinane. 2024.111469.