Bilateral brachial plexus block. Case reporting and systematic review of literature

Published on Jul 1, 2015in Cirugia Y Cirujanos0.264
· DOI :10.1016/J.CIRCEN.2015.09.008
Gabriel Enrique Mejía-Terrazas3
Estimated H-index: 3
María de Ángeles Garduño-Juárez2
Estimated H-index: 2
+ 2 AuthorsRaúl Carrillo-Esper10
Estimated H-index: 10
Abstract Background The bilateral brachial plexus block is considered a contraindication, due to the possible development of complications, such as toxicity from local anaesthetics or bilateral diaphragmatic paralysis. However, with the real time visualisation provided by the ultrasound scan, these complications have decreased and it is a safer procedure. Clinical cases Four cases are presented where the bilateral block was performed using guided ultrasound, as the patients were unable to receive general anaesthesia due to a history of adverse effects or the use of opioids in the post-operative or by the prediction of a difficult airway associated with obesity. A systematic review of the literature from January 1993 to June 2013, was also performed by using a search in the MEDLINE, EMBASE, ARTEMISA, LILACS, Google data bases, in Spanish and English language with the following words: bilateral brachial plexus block, bilateral interscalene block, bilateral infraclavicular block, bilateral supraclavicular block, bilateral lateral supraclavicular block, bilateral axillary block, ultrasound-guided bilateral brachial plexus block. Conclusion Based on the evidence found, ultrasound-guided bilateral brachial plexus block in selected patients and expert hands, is no longer a contraindication.
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