title: An abnormal clinical course of an ultrasound-guided supraclavicular brachial plexus block using 0.375% bupivacaine.
abstract: We report on the case of a reappearance of a supraclavicular nerve block after the apparent initiation of its resolution in a 21-year-old athlete undergoing repair of a valgus impaction syndrome of his right elbow. The patient's anesthetic management consisted of a supraclavicular nerve block and general anesthesia. The patient was discharged home with an apparent resolving nerve block. He returned to the hospital urgently when, at 7 hours after blockade, he lost all motor-sensory function in his arm. His workup ultimately yielded negative results, and the block resolved at 23 hours. In addition to documenting an abnormal course of a supraclavicular block, this case report questions the appropriateness of placing long-acting nerve blocks in outpatients.
authors.affiliation: Department of Anesthesiology, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. brian.sites@hitchcock.org
authors.forename: Brian D
authors.initials: BD
authors.lastname: Sites
authors.forename: Marc L
authors.initials: ML
authors.lastname: Bertrand
authors.forename: John D
authors.initials: JD
authors.lastname: Gallagher
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000494:pharmacology*; D001917:Brachial Plexus; D002045:Bupivacaine / Q000494:pharmacology*; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000009:adverse effects*; D013997:Time Factors; D014465:Ultrasonics
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine