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Brachial plexus injury from CT-guided RF ablation under general anesthesia
Sridhar Shankar1, Eric Vansonnenberg, Stuart G Silverman
1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 01655, USA. shankars@ummhc.org
Cardiovascular and Interventional Radiology
|August 11, 2005
Summary
Brachial plexus injury can occur during general anesthesia due to prolonged positioning. Awareness and preventative measures are crucial for radiologists to avoid this complication.
Area of Science:
- Radiology
- Anesthesiology
- Neurology
Background:
- Brachial plexus injury (BPI) is a known complication during general anesthesia (GA).
- Patient positioning in the computed tomography (CT) gantry, especially with arms elevated, increases BPI risk.
- Prolonged procedures exacerbate the risk of stretching and compression injuries to the brachial plexus.
Observation:
- A case of profound brachial plexus palsy is reported following a CT-guided radiofrequency ablation under GA.
- The injury mechanism involved prolonged stretching and compression of the brachial plexus.
- The patient experienced complete recovery from the palsy.
Findings:
- CT-guided procedures under GA, particularly those requiring prolonged arm elevation, pose a significant risk for brachial plexus injury.
- The risk is amplified by the duration of the procedure and specific patient positioning.
- Radiologists must be vigilant for this potentially serious complication.
Implications:
- Increased awareness among radiologists regarding BPI during CT-guided procedures is essential.
- Implementing specific preventative measures during patient positioning can mitigate the risk.
- Early recognition and management can lead to favorable patient outcomes, as demonstrated by complete recovery.