CRCM  Vol.3 No.3 , March 2014
Transient Ipsilateral Lower Limb Paresis after Interscalene Brachial Plexus Block
ABSTRACT

We describe a partial motor block of ipsilateral lower limb after interscalene block with the injection of 40 ml of 0.5% bupivacaine and 2% lignocaine with adrenaline. Immediately after the block, patient reported a right motor hemi syndrome which was transient. We concluded that the neurological symptom was caused by the technique of interscalene brachial plexus block may be as a result of excessive lateral deviation of the neck with a compromised collateral circulation.


Cite this paper
Idehen, O. and Amadasun, F. (2014) Transient Ipsilateral Lower Limb Paresis after Interscalene Brachial Plexus Block. Case Reports in Clinical Medicine, 3, 157-160. doi: 10.4236/crcm.2014.33038.
References
[1]   Passannate, A.N. (1996) Spinal Anaesthesia and Permanent Neurological Deficit after Interscalene Block. Anesthesia and Analgesia, 82, 873-874.

[2]   Kumar, A., Battit, G.E., Froese, A.B., Long, M.C., et al. (1971). Bilateral Cervical and Thoracic Epidural Blockade Complicating Interscalene Block: Report of Two Cases. Anesthesiology, 35, 650-652.
http://dx.doi.org/10.1097/00000542-197112000-00022

[3]   Barutell, C., Vidal, F., Raich, M. and Montero, A. (1980) A Neurological Complication Following Interscalene Brachial Plexus Block. Anaesthesia, 35, 365-367. http://dx.doi.org/10.1111/j.1365-2044.1980.tb05119.x

[4]   Fraust, A., Fournier, R., Hagon, O., Hoffmeyer, P. and Gamulin, Z. (2006) Partial Sensory and Motor Deficit of Ipsilateral Lower Limb after Continuous Interscalene Block. Anesthesia and Analgesia, 102, 1288-1290.

[5]   Long, T.R., Wass, C.T. and Burkle, C.M. (2002) A Perioperative Interscalene Blockade: An Overview of Its History and Current Clinical Use. Journal of Clinical Anaesthesia, 14, 546-556.
http://dx.doi.org/10.1016/S0952-8180(02)00408-7

[6]   Lanna, M., Pastere, A., Policastro, C. and Lacovazzo, C. (2012) Anesthesiological Consideration in Shoulder Surgery. Translational Medicicne @ UniSa, 3, 42-48.

[7]   Annon. Floorplan. (2012). http://www.neuraxiom.com/html/lloorphp

[8]   Walton, J.S., Folk, J.W., Friedman, R.J. and Dorman, B.H. (2000) Complete Brachial Plexus Palsy after Total Shoulder Arthroplasty Done with Interscalene Block Anaesthesia. Regional Anesthesia and Pain Medicine, 25, 318-321.

[9]   Urmey, W.F. and McDonald, M. (1992) A Hemi Diaphragmatic Paresis during Interscalene Brachial Plexus Block: Effect on the Pulmonary Function and Chest Wall Mechanics. Anesthesia and Analgesia, 74, 352-357.

[10]   Sameer, M.J., Rajesh, P.C. and Parthasarathy, S. (2012) Transient Hypertension after Interscalene Block—The Presentation of a Rare Complication with an Anatomical Explanation. Journal of Clinical and Diagnostic Research, 10, 1768-1769.

[11]   Cook, L.B. (1991) Unsuspected Extradural Catherization in an Interscalene Block. British Journal of Anesthesia, 67, 473-475. http://dx.doi.org/10.1093/bja/67.4.473

[12]   Mohoudeau, G., Gaertner, E., Launoy, A., Ocquident, P. and Loewanthal, A. (1995) Interscalene Block: Accidental Epidural Space Catherization. Annales Françaises d’Anesthésie et de Réanimation, 14, 438-441.

[13]   Borgeat, A., Ekatodramis, G., Kalberer, F. and Benz, C. (2001) Acute and None Acute Complication Associated with Interscalene Block and Shoulder Surgery. Anesthesiology, 95, 875-880.
http://dx.doi.org/10.1097/00000542-200110000-00015

[14]   Fredrickson, M.J. and Kelfoyle, D.H. (2009) Neurological Complication Analysis of 1000 Ultrasound Guided Peripheral Nerve Blocks for Elective Orthopaedic Surgery: A Prospective Study. Anesthesia, 64, 836-844.
http://dx.doi.org/10.1111/j.1365-2044.2009.05938.x

 
 
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