Anesthetic management for upper arm amputation in a patient with acute rapid atrial fibrillation and a large thyroid goiter: A case report

Figure 1.. Patient imaging data. (A) Schematic diagram of the patient’s thyroid mass. (B) Chest computed tomography scan showing significant enlargement of the left lobe of the thyroid gland, measuring 110 × 70 mm in size.

Figure 2.. Schematic diagram of ultrasound-guided needle placement for nerve blocks. (C) Final ultrasound transducer position for ultrasound-guided subclavian perivascular brachial plexus block at the interscalene space, identifying the subclavian artery and visualizing the medial, posterior, and lateral cords of the brachial plexus, as well as the pleura beneath them, at 3, 7, and 9 o’clock positions relative to the artery. The “in-plane” approach is utilized for needle insertion. (D) Final ultrasound transducer position for ultrasound-guided intercostobrachial nerve block via the axillary region, with the head placed horizontally at the top of the axilla. The intercostobrachial nerve (ICBN) is visualized within the fatty layer posterior and superior to the axillary vein, between the lines connecting the edges of the teres major and latissimus dorsi muscles. AXA = axillary artery; AXV = axillary vein; ICBN = intercostobrachial nerve; Lats = latissimus dorsi muscle; PM = pectoralis major muscle; subclavius = subclavius muscle; white triangle indicates the trajectory of the needle insertion.