title: Total spinal anaesthesia after an attempted brachial plexus block using the posterior approach.
abstract: A 66-year-old patient scheduled for elective shoulder surgery underwent a brachial plexus block using the posterior approach. Shortly after injection of the local anaesthetic, he rapidly became unresponsive and apnoeic. We identify the possible reasons for this occurrence and discuss the place of the posterior approach in brachial plexus anaesthesia.
authors.affiliation: Department of Anaesthesiology, Leiden Universital Medical Center, Leiden, PO Box 6900, 2300 RC, Leiden, The Netherlands. j.m.grefkens@lumc.nl
authors.forename: J M
authors.initials: JM
authors.lastname: Grefkens
authors.forename: K
authors.initials: K
authors.lastname: Bürger
mesh_terms: D000368:Aged; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000009:adverse effects; D001049:Apnea / Q000139:chemically induced; D019643:Arthroplasty, Replacement / Q000379:methods; D001917:Brachial Plexus; D002045:Bupivacaine / Q000009:adverse effects / Q000031:analogs & derivatives; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D009407:Nerve Block / Q000379:methods*; D012785:Shoulder Joint / Q000601:surgery
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine