Brachial Plexus Block in Lateral Position for Fracture Shaft Humerus in Severe Thoracic Kyphoscoliosis- A Case Report

Vol 4 | Issue 2 | July-December 2023 | Page 18-20 | Sandeep Mutha, Sushmitha K, Rajan Kothari, Deepak Phalgune

DOI: https://doi.org/10.13107/ijra.2023.v04i02.078

Submitted: 24-03-2023; Reviewed: 16-04-2023; Accepted: 11-10-2023; Published: 10-12-2023


Authors: Sandeep Mutha [1], Sushmitha K [1], Rajan Kothari [2], Deepak Phalgune [3]

[1] Department of Anaesthesiology, Poona Hospital and Research Centre, Pune, Maharashtra, India.
[2] Department of Orthopaedic Surgery, Poona Hospital and Research Centre, Pune, Maharashtra, India.

Address of Correspondence
Dr. Deepak Phalgune
Research Consultant, Poona Hospital & Research Centre, Pune, Maharashtra, India.
Email- dphalgune@gmail.com


Abstract

Patients with spine deformities, present unique challenges to the anaesthesiologists. These patients have abnormalities such as cardiovascular, pulmonary, musculo-skeletal, etc. Spinal deformities may cause difficulties with ventilation, tracheal intubation, regional anaesthesia and positioning. Due to problems associated with respiratory system, regional anaesthesia is widely preferred, though it is technically and logistically difficult. We present a case report of the anaesthetic management of an elderly female with severe thoracic kyphoscoliosis who could not lie supine on bed. She had a fracture of left upper 1/3rd shaft humerus. She was posted for open reduction and internal fixation of fractured shaft of left humerus under brachial plexus nerve block in right lateral position with a pillow under the head. The patient was given left interscalene and costoclavicular (infraclavicular) brachial plexus block under ultrasonography and peripheral nerve stimulator guidance. Major problems for brachial plexus block were positioning, approach, dosage of medications and respiratory compromise. Another difficulty was the position of the patient during the surgical procedure. The surgery was successful and the patient was pain free both intra and postoperatively. Intraoperatively no sedation or anxiolysis were required
Keywords: Kyphoscoliosis, Brachial plexus block, Fracture humerus, Patient position.


References


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How to Cite this Article:   Mutha S, Sushmitha K, Kothari R, Phalgune D | Brachial Plexus Block in Lateral Position for Fracture Shaft Humerus in Severe Thoracic Kyphoscoliosis- A Case Report | International Journal of Regional Anaesthesia | July-December 2023; 4(2): 18-20 | DOI: https://doi.org/10.13107/ijra.2023.v04i02.078


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