Bilateral Brachial Plexus Block Using Chloroprocaine For Surgery Of Bilateral Radial Fractures

Abstract

We report a case of a 41-year-old male with anticipated difficult airway undergoing a repair of a bilateral radial fracture under bilateral sequential brachial plexus block. Anesthesiologists are reluctant to perform bilateral blocks because of the fear of complications like diaphragmatic paralysis, local anesthetic (LA) toxicity, and pneumothorax. We advise that with the correct application of LA pharmacokinetics, careful patient selection and usage of ultrasound, bilateral blocks can be done safely. We used chloroprocaine as an LA in one of the blocks to reduce the dose required for the more toxic LAs. chloroprocaine’s fast metabolism also helped us to prevent the overlapping of peak plasma concentration of different LAs. To our knowledge, this is the first reported case in the literature where chloroprocaine was used for bilateral brachial plexus block.

Keywords:

• brachial plexus block
• local anesthetics (LA)
• chloroprocaine

Consent Statement

As the patient has been lost to follow up, patient consent for publication of this case was not possible. The details have been sufficiently anonymized not to cause harm to the patient.

Disclosure

The authors report no conflicts of interest in this work.