title: Interscalene and infraclavicular block for bilateral distal radius fracture.
abstract: Brachial plexus blockade is a suitable technique for surgery of the forearm, because it provides good intraoperative anesthesia as well as prolonged postoperative analgesia when long-acting local anesthetics are used. However, simultaneous blockade of both upper extremities has rarely been performed (1), because local anesthetic toxicity caused by the amount of drug needed to achieve an efficient block on both sides may be a problem. We report a case of successful bilateral brachial plexus block with ropivacaine in a patient with bilateral distal radius fracture, with each fracture requiring an open osteosynthesis.
  
  
  CONCLUSIONS
  This case report presents the performance of a simultaneous blockade of both upper extremities in a patient who sustained a bilateral distal radius fracture. The patient was known to be difficult to intubate and to have a severe hypersensitivity to opioids.
authors.affiliation: Department of Anesthesiology, University Hospital Zurich/Balgrist, Zurich, Switzerland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Maurer
authors.forename: Georgios
authors.initials: G
authors.lastname: Ekatodramis
authors.forename: Katharina
authors.initials: K
authors.lastname: Rentsch
authors.forename: Alain
authors.initials: A
authors.lastname: Borgeat
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage / Q000493:pharmacokinetics; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000493:pharmacokinetics; D001917:Brachial Plexus; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D009407:Nerve Block / Q000379:methods*; D011885:Radius Fractures / Q000601:surgery*; D000077212:Ropivacaine; D012865:Skiing / Q000293:injuries
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine