Prolonged Interscalene Blockade for 30 Hours with 0.5% Plain Bupivacaine in a Case of Shoulder Arthroscopy

Abstract

We present a case of unusually prolonged motor and sensory block for 30 hours after a successful single injection of ultrasound-guided interscalene block with 0.5% plain bupivacaine. All safety measures such as negative aspiration of blood injection at every 3 mL of drug with usual resistance, slow rate of injection and ultrasound documentation of spread of drug around C 5 and C 6 were followed. There was no evidence of neurological injury, but we should always be prepared to consider the possibility of nerve injury and take appropriate measures to prevent them.

Ultrasound-guided interscalene block is effective for anesthesia and postoperative analgesia for clavicle fracture surgery

“…The brachial plexus is entirely wrapped in a fascial covering so that it is shaped like a tube; so that if an injection of adequate volume of local anesthetic is carried out in the tube, it will produce a complete block in the involved nerves in most of the cases. 16 This plexus-covering tube is directly connected to the cervical plexus nerves. Injections in the interscalene groove as high as C-6 (cricoid level) usually results in an anesthetic block equally well in the lower cervical plexus.…”