[A case of nerve injury after vascular access surgery under brachial plexus block].
A 52-year-old woman underwent vascular access surgery under brachial plexus block of the left arm. After the surgery, the patient complained of painful and burning sensation and motor disturbance of her forearm without muscle necrosis. We administered ketamine to treat the symptoms as neuropathic pain arising as a complication of brachial plexus nerve block. Six days after operation, angiography showed little blood flow at distal portion of the shunt. We recognized ischemia induced monomeric neuropathy. Immediately after the occlusion of the vascular access, the pain disappeared but not sensory and motor disturbances. Our experience suggests that angiography is helpful for diagnosis of ischemia-induced neuropathy after vascular access surgery.
Imashuku
Yasuhiko
Y
Department of Anesthesiology, Shiga University of Medical Science, Otsu 520-2192.
Kitagawa
Hirotoshi
H
Takahashi
Kan
K
Ishii
Tsutomu
T
Iwashita
Narihito
N
D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001917:Brachial Plexus; D005260:Female; D005542:Forearm / Q000098:blood supply / Q000294:innervation; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects*; D010525:Peripheral Nerves / Q000098:blood supply; D010523:Peripheral Nervous System Diseases / Q000209:etiology*