Key result
Supraclavicular brachial plexus block in severe COPD linked to hypercarbia-induced bronchospasm and unconsciousness.
Case Report (n=1)
No
Ultrasound-guided supraclavicular brachial plexus block can cause severe complications such as hypercarbia-induced bronchospasm and unconsciousness in vulnerable patients with compromised respiratory function.
Case of respiratory compromise post-supraclavicular block in severe COPD warrants caution; leaves open safer anesthetic strategies for advanced lung disease.
Though the popularity of brachial plexus block for upper limb surgery is well known fact, but, one must not forget the complications associated with it.Herein, we report a middle aged obese female with fracture olecranon and proximal end of radius was posted for tension band wiring of olecranon process under ultrasound guided supraclavicular brachial plexus block.She was a known case of chronic obstructive pulmonary disease (COPD), with severe lung fibrosis and collapse, pleural thickening and mediastinal shift to the same side where she had to be operated.After repeated referral for optimization to tuberculosis and respiratory diseases she was posted for surgery after explaining the high risk involved to the patient.Following completion of procedure, she turned supine from lateral decubitus position, found unconscious and tachypnoeic.On auscultation, there was severe bronchospasm/silent chest; was immediately intubated and managed with difficulty.
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Shahla Haleem (2016) conducted a case report in Fracture olecranon and proximal end of radius in a patient with COPD (n=1). Ultrasound-guided supraclavicular brachial plexus block was evaluated on Development of complications (unconsciousness and severe bronchospasm). Ultrasound-guided supraclavicular brachial plexus block in a patient with severe COPD and lung fibrosis led to hypercarbia-induced severe bronchospasm and unconsciousness.
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