[Brachial plexus. Long lasting neurological deficit following interscalene blockade of the brachial plexus].
An interscalene block of the brachial plexus was combined with general anaesthesia for repair of a complex chronic lesion of the shoulder. The localisation of the plexus with electro-stimulation and the injection of Bupivacain 0.5% were accomplished easily and without painful sensations. 48 hours later the block was still partially present. Paraesthesia and a sensory and motor innervation deficit affected mainly the dorsal fascicle, but also areas innervated by the median and lateral fascicles. The deficit did not completely disappear for 18 month. The cause could have been due to direct traumatisation during blockade or operation, toxic action of the injected substance (Bupivacain 0.5%, 30 ml), distension of the plexus, a cervical syndrome or an aseptic plexitis, although a definite determination is not possible. However, the pattern of the lesion and the lack of pain during localisation of the plexus and injection favour traumatisation during the acromioplasty.
Funk
W
W
Klinik für Anaesthesiologie, Klinikum der Universität Regensburg. Wolfgang.Funk@klinik.uni-regensburg.de
Angerer
M
M
Sauer
K
K
Altmeppen
J
J
D000328:Adult; D000779:Anesthetics, Local; D001917:Brachial Plexus; D002045:Bupivacaine; D006801:Humans; D008297:Male; D009046:Motor Neurons / Q000187:drug effects; D009407:Nerve Block / Q000009:adverse effects*; D019637:Orthopedic Procedures; D010147:Pain Measurement; D010292:Paresthesia / Q000139:chemically induced; D012678:Sensation Disorders / Q000139:chemically induced; D012782:Shoulder / Q000601:surgery
D000779:Anesthetics, Local; D002045:Bupivacaine