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Revista Mexicana de Anestesiología

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ISSN 0484-7903 (Print)
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2012, Number 4

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Rev Mex Anest 2012; 35 (4)

Deep coma and respiratory arrest as a complication of interscalene brachial plexus block

Martínez-López MP, Beleña-Burgos JM, Alonso-Pereiro E, Yuste-Echarren FJ
Full text How to cite this article

Language: Spanish
References: 10
Page: 283-285
PDF size: 64.80 Kb.


Key words:

Deep coma, respiratory failure, interscalene block.

ABSTRACT

The interscalene approach is the more proximal technique for brachial plexus block, mainly indicated for shoulder and proximal upper limb surgery. We present the case of a 55-yr-old woman that went into deep coma and respiratory failure, with no haemodynamic instability, after interscalene block that achieved satisfactory evolution, regaining consciousness and recovering the mobility of her limb 2-3 hours after the block. Central diffusion (epidural block, subdural block and intrathecal or total spinal anesthesia) is a rare but serious complication caused by a direct puncture through an intervertebral foramen (usually C6-C7). We discuss the different etiologies of this complication


REFERENCES

  1. Winnie AP. Interescalene brachial plexus block. Anesth Analg 1970;49(3):455-66.

  2. Borgeat A, Ekatodramis G, Kalberer F, Benz C. Acute and nonacute complications associated with interescalene block and shoulder surgery: a prospective study. Anesthesiology 2001;95(4):875-80.

  3. Gomez RS, Mendes TC. Epidural anaesthesia as a complication of attempted brachial plexus blockade using the posterior approach. Anaesthesia 2006;61(6):591-2.

  4. Scammell SJ . Case report: inadvertent epidural anaesthesia as a complication of interescalene brachial plexus block. Anaesth Intensive Care 1979: 7: 56-57.

  5. Mahoudeau G, Gaertner E, Launoy A, Ocquidant P, Loewenthal A, Ann Fr. Interscalenic block: accidental catheterization of the epidural space. Anesth Reanim 1995;14(5):438-41.

  6. Tetzlaff JE, Yoon HJ, Dilger J, Brems J. Subdural anesthesia as a complication of an interscalene brachial plexus block. Case report. Reg Anesth 1994;19(5):357-9.

  7. Grefkens JM, Bürger K. Total spinal anaesthesia after an attempted brachial plexus block using the posterior approach. Anaesthesia 2006;61(11):1105-8.

  8. Walter M, Rogalla P, Spies C, Kox WJ, Volk T. Intrathecal misplacement of an interscalene plexus catheter. Anaesthesist 2005; 54(3):215-9.

  9. Iocolano CF. Total spinal anesthesia after an interscalene block. J Perianesth Nurs. 1997;12(3):163-8.

  10. Tornero JC, Gómez M, Fabregat G, Aliaga L. Complicaciones tras técnicas de anestesia regional. Rev Esp Anestesiol Reanim 2008;55:552-62.




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Rev Mex Anest. 2012;35