Bilateral brachial plexus block. Case report and systematic review

Published on Jun 25, 2015in Cirugia Y Cirujanos0.264
· DOI :10.1016/J.CIRCIR.2015.05.018
Gabriel Enrique Mejía-Terrazas3
Estimated H-index: 3
Garduño-Juárez Mde Á1
Estimated H-index: 1
+ 2 AuthorsRaúl Carrillo-Esper10
Estimated H-index: 10
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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Last. A. Arshad (AIIMS: All India Institute of Medical Sciences)
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#2David B. AuyongH-Index: 14
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