Beyond the Brachial Plexus: Reapplication of the Thoracic Paravertebral Block for Upper Arm Fistula Surgery.

arterio-venous fistula clinical case report regional anesthesiology supraclavicular brachial plexus block thoracic paravertebral block upper limb surgery

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
Aug 2023
Historique:
accepted: 31 07 2023
medline: 4 9 2023
pubmed: 4 9 2023
entrez: 4 9 2023
Statut: epublish

Résumé

Patients requiring complex upper arm arteriovenous fistulas or grafts may not be suitable candidates for a single regional anesthesia technique and monitored anesthesia care because the necessary thoracic (T2) dermatomal area of the medial, upper arm remains spared by any solitary brachial plexus (C5-T1) technique. An infiltrative intercostobrachial nerve block can often be used in conjunction with a brachial plexus block; however, coverage may still be incomplete. This case report describes the use of a high thoracic paravertebral block in conjunction with a brachial plexus block to achieve adequate anesthetic coverage for an upper arm arteriovenous fistula creation procedure extending into the axilla. The result of this technique showed adequate coverage of the upper arm and demonstrates that paravertebral blocks are a reasonable adjunct for proximal upper arm arteriovenous fistula procedures.

Identifiants

pubmed: 37664292
doi: 10.7759/cureus.42863
pmc: PMC10473444
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e42863

Informations de copyright

Copyright © 2023, Krakowski et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

James C Krakowski (JC)

Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA.

Daniel T Le (DT)

Department of Anesthesiology, Naval Medical Center San Diego, San Diego, USA.

Stuart A Grant (SA)

Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA.

Classifications MeSH