Brachial Plexus Neuropathy: A Rare Complication of Patient Positioning during Interventional Radiologic Procedures

1999 ◽  
Vol 10 (5) ◽  
pp. 579-582 ◽  
Author(s):  
Scott J. Savader ◽  
David G. Omdal ◽  
Anthony C. Venbrux
Keyword(s):  
Brachial Plexus ◽  
Rare Complication ◽  
Patient Positioning

Prolonged brachial plexus neuropathy: a rare complication following protracted endometriosis surgery in Lloyd-Davies position

2021 ◽  
Vol 14 (11) ◽  
pp. e243408
Author(s):  
Anna Katrina Hay ◽  
Anna McDougall ◽  
Peter Hinstridge ◽  
Sanjeev Rajakuldendran ◽  
Wai Yoong
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Rare Complication ◽  
Patient Positioning ◽  
Sensory Innervation ◽  
Plexus Brachialis ◽  
Clinical Anatomy ◽  
Reduction Strategies ◽  
Risk Reduction Strategies ◽  
Endometriosis Surgery

Brachial plexus injury is a rare but potentially serious complication of laparoscopic surgery. Loss of motor and/or sensory innervation can have a significant impact on the patient’s quality of life following otherwise successful surgery. A 38-year-old underwent elective laparoscopic management of severe endometriosis during which she was placed in steep head-down tilt Lloyd-Davies position for a prolonged period. On awakening from anaesthesia, the patient had no sensation or movement of her dominant right arm. A total plexus brachialis injury was suspected. As advised by a neurologist, an MRI brachial plexus, nerve conduction study and electromyography were requested. She was managed conservatively and made a gradual recovery with a degree of residual musculocutaneous nerve neuropathy. The incidence of brachial plexus injury following laparoscopy is unknown but the brachial plexus is particularly susceptible to injury as a result of patient positioning and prolonged operative time. Patient positioning in relation to applied clinical anatomy is explored and risk reduction strategies described.

scholarly journals Compartment Syndrome Related to Patient Positioning in the Surgical Treatment of Urolithiasis

2021 ◽  
Author(s):  
Inés Laso-García ◽  
Fernando Arias-Fúnez ◽  
Gemma Duque-Ruiz ◽  
David Díaz-Pérez ◽  
Alberto Artiles-Medina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Compartment Syndrome ◽  
Percutaneous Nephrolithotomy ◽  
Rare Complication ◽  
Patient Positioning ◽  
Lower Limbs ◽  
Urinary Stones ◽  
Ureteral Stones ◽  
Lithotomy Position ◽  
American Society

The incidence of urolithiasis is progressively increasing worldwide, as is the surgical treatment of urinary stones. The most frequent surgery for urolithiasis is ureterorenoscopy, which is performed in the lithotomy position. This position is also used in the endoscopic approach to bladder stones. Lateral decubitus is rarely used in the treatment of urinary stones. In the case of complex kidney stones, the gold standard treatment is percutaneous nephrolithotomy. This surgery has traditionally been performed in the prone position. However, the use of the supine (Valdivia) position is increasing in recent times. Furthermore, the Galdakao-modified supine Valdivia position has been widely used for percutaneous nephrolithotomy since it was described by Ibarluzea et al. in 2007. Treatment of kidney and ureteral stones simultaneously is allowed in both supine positions. In addition, they allow the removal of encrusted stents and the easy placement of double J stents and, in the case of the Galdakao-modified supine Valdivia position, percutaneous nephrostomies. Compartment syndrome is a rare complication in the lithotomy position, but scarcely described in the supine position. This especially applies to the Galdakao-modified supine Valdivia position, in which the lower limbs are in moderate flexion, with the ipsilateral lower limb in a slightly lower position relative to the other. This complication can lead to skin necrosis, myoglobinuric renal failure, amputation, permanent neuromuscular dysfunction, and even death. Risk factors include Body Mass Index, male gender, obesity, increased muscle mass, peripheral vascular disease (advanced age, hypertension, hyperlipidemia and diabetes mellitus), height, lack of operative experience, significant bleeding during surgery, hypothermia, acidemia, combination general-spinal anesthesia, prolonged surgical time, systemic hypotension, ASA (American Society of Anesthesiologists) class or vasoconstrictor drugs. Therefore, compartment syndrome of the leg is a potentially devastating complication that must be suspected and treated through early decompression of the compartment by four compartment fasciotomy. Preventive measures reduce the incidence of this condition.

scholarly journals A Rare Complication in Ultrasound-guided Supraclavicular Brachial Plexus Block

2016 ◽  
Vol 1 (1) ◽  
pp. 30-31
Author(s):  
Sindil Kumar Sahu ◽  
Usha Badole
Keyword(s):  
Brachial Plexus ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Brachial Plexus Block ◽  
Rare Complication ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Ultrasound Guided ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

ABSTRACT Orthopaedic upper limb surgeries are commonly performed under brachial plexus block. Ultrasound guidance significantly improves the quality of nerve block with lesser number of complications, although complications cannot be eliminated completely. Ipsilateral recurrent laryngeal nerve palsy is a rare complication associated with supraclavicular approach. We report a case of 28 year old female who developed hoarseness of voice following ultrasound guided supraclavicular brachial plexus block. The diagnosis of ipsilateral recurrent laryngeal nerve palsy requires a high index of suspicion and it should always be kept in differential diagnosis when a patient develops hoarseness of voice or respiratory compromise after supraclavicular brachial plexus block. How to cite the article Sahu SK, Badole U. A Rare Complication in Ultrasound-guided Supraclavicular Brachial Plexus Block. Res Inno Anaesth 2016;1(1):30-31.

Brachial Plexus Injury Related to Patient Positioning

2007 ◽  
Vol 18 (7) ◽  
pp. 833-834 ◽  
Author(s):  
Anil Kumar Pillai ◽  
Hector Ferral ◽  
Sudhen Desai ◽  
Sudheer Paruchuri ◽  
Scott Asselmeier ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Patient Positioning

RADIAL HEAD DISLOCATION AS A RARE COMPLICATION OF OBSTETRIC BRACHIAL PLEXUS PALSY: LITERATURE REVIEW AND FIVE CASE SERIES

Hand Surgery ◽  
2012 ◽  
Vol 17 (01) ◽  
pp. 33-36 ◽  
Author(s):  
Cecilia W. Huo
Keyword(s):  
Brachial Plexus ◽  
Radial Head ◽  
Biceps Tendon ◽  
Rare Complication ◽  
Case Series ◽  
Annular Ligament ◽  
Radial Head Dislocation ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus

Radial head dislocation secondary to obstetric brachial plexus palsy is a rare complication that may occur a few years after birth. Five cases were examined and a comprehensive literature search was performed. Although it is a concern for parents, the dislocation resulted in mild or minimal functional impairment for all five children. Surgical interventions such as biceps tendon transfer, radial head open reduction or excision and annular ligament reconstruction were largely ineffective in significantly improving ranges of motion. Clinicians should be aware of the potentially futile outcomes and risks associated with the surgical treatment of radial head dislocation.

scholarly journals Hoarseness of Voice following Left Supraclavicular Brachial Plexus Block: A Case Report

2021 ◽  
Vol 59 (241) ◽  
pp. 925-928
Author(s):  
Subin Shrestha ◽  
Sadikshya Regmi ◽  
Gopendra Deo ◽  
Indra Narayan Shrestha
Keyword(s):  
Brachial Plexus ◽  
Recurrent Laryngeal Nerve ◽  
Brachial Plexus Block ◽  
Rare Complication ◽  
Local Anaesthetics ◽  
Laryngeal Nerve ◽  
Ultrasound Guided ◽  
Supraclavicular Brachial Plexus Block ◽  
Supraclavicular Block ◽  
Plexus Block

Supraclavicular brachial plexus block is extensively used for primary regional anaesthesia as well as postoperative analgesia for the surgical procedures of the upper limb. The evidence for the use of ultrasound in supraclavicular brachial plexus is growing day by day as it has the advantage of allowing real time visualisation of the plexus, pleura and vessels along with the needle and local anaesthetics spread. Despite this, complications can even arise with ultrasound guided supraclavicular brachial plexus block. Hoarseness of voice due to recurrent laryngeal nerve block is a rare complication of supraclavicular brachial plexus block. There are few reported cases of hoarseness of voice following the right supraclavicular block. There is only one reported case of hoarseness of voice following the left supraclavicular block. Here, we report a case of a 16-year-old boy who developed hoarseness of voice due to left recurrent laryngeal nerve following ultrasound guided left supraclavicular brachialplexus block.

Brachial plexus injury following spinal surgery

2010 ◽  
Vol 13 (4) ◽  
pp. 552-558 ◽  
Author(s):  
Juan S. Uribe ◽  
Jaya Kolla ◽  
Hesham Omar ◽  
Elias Dakwar ◽  
Naomi Abel ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Spinal Surgery ◽  
Brachial Plexus Injury ◽  
Patient Positioning ◽  
Electrophysiological Monitoring ◽  
Duration Of Surgery ◽  
Intraoperative Electrophysiological Monitoring ◽  
Special Concern ◽  
Injury Recovery ◽  
Determining Factor

Object In the present study, the authors identified the etiology, precipitating factors, and outcomes of perioperative brachial plexus injuries following spine surgery. Methods We reviewed all the available literature regarding postoperative/perioperative brachial plexus injuries, with special concern for the patient's position during surgery, duration of surgery, the procedure performed, neurological outcome, and prognosis. We also reviewed the utility of intraoperative electrophysiological monitoring for prevention of these complications. Results Patient malpositioning during surgery is the main determining factor for the development of postoperative brachial plexus injury. Recovery occurs in the majority of cases but may require weeks to months of therapy after initial presentation. Conclusion Brachial plexus injuries are an increasingly recognized complication following spinal surgery. Proper attention to patient positioning with the use of intraoperative electrophysiological monitoring techniques could minimize injury.

Sign in / Sign up

Export Citation Format

Share Document