Epidural anaesthesia as a complication of attempted brachial plexus blockade using the posterior approach

Abstract

Summary We report a case of accidental epidural anaesthesia as a complication of attempted brachial plexus blockade using a posterior approach in a 31‐year‐old man scheduled to undergo elective shoulder surgery. The block was inserted with the patient in the lateral position before induction of general anaesthesia. On emergence from anaesthesia, the patient could breathe but could not move his arms. He had no pain sensation from the fifth cervical dermatome to the third thoracic dermatome bilaterally; this resolved 8 h after surgery and he was discharged well 2 days later. Although proponents of the posterior approach to the brachial plexus claim that its use is associated with a lower incidence of significant complications, this case proves that the technique is not devoid of potentially serious complications.

Bilateral Loss of Neural Function After Interscalene Plexus Blockade May Be Caused by Epidural Spread of Local Anesthetics

“…To our knowledge, there is only 1 reported case of epidural spread following a nerve stimulator ISB, 19 whereas there are multiple reports of this complication using a paresthesia technique. 6,8Y10 There has been 1 case report on contralateral neural deficit after US-controlled interscalene plexus block.…”

Comparison of three techniques for paravertebral brachial plexus blockade in dogs

“…Some potential clinical complications associated with PBPB in animals extrapolated from complications observed in humans following an analogous (Dutton et al 1994;Aramideh et al 2002;Gomez & Mendes 2006;Riazi et al 2008). In the present study, the most common complication was presence of dye around the spinal cord (29-39%) with all techniques, especially close to the exit of C6 and C7 nerves, where the injections were made at the level of the IVF.…”

“…In the present study, the most common complication was presence of dye around the spinal cord (29-39%) with all techniques, especially close to the exit of C6 and C7 nerves, where the injections were made at the level of the IVF. In humans, cervical epidural or spinal anesthesia (Dutton et al 1994;Aramideh et al 2002;Gomez & Mendes 2006) and brainstem toxicity (Durrani & Winnie 1991) have been reported after a brachial plexus block using a similar approach. Epidural and/or spinal anesthesia at the cervical level could lead to life-threatening respiratory and cardiovascular depression in clinical cases (Aramideh et al 2002).…”

Ultrasound‐guided training in the performance of brachial plexus block by the posterior approach: an observational study

“…After a slight needle adjustment, muscle contractions were produced. Needle placement was accurate in a median [range] of 2 [1][2][3][4] attempts. In nine patients, the brachial plexus was found at the first attempt.…”