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Pneumothorax after coracoid infraclavicular brachial plexus block
James C Crews1, J C Gerancher, Robert S Weller
1Department of Anesthesiology, Section on Regional Anesthesia and Acute Pain Management, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1009, USA. jcrews@wfubmc.edu
Anesthesia and Analgesia
|June 21, 2007
Summary
The coracoid infraclavicular brachial plexus block is popular for its safety. However, this case report highlights a rare pneumothorax complication, emphasizing careful landmark identification during the procedure.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Thoracic Complications
Background:
- The infraclavicular brachial plexus block is a common regional anesthesia technique.
- The coracoid infraclavicular approach is favored for its accessible landmarks and low complication rates.
- Pneumothorax is a recognized but infrequent risk associated with brachial plexus blocks.
Observation:
- A case of pneumothorax occurred in a patient following a coracoid infraclavicular brachial plexus block.
- This complication arose despite the technique's general reputation for safety.
- Potential contributing factors include subtle inaccuracies in landmark identification or measurement.
Findings:
- The coracoid infraclavicular brachial plexus block, while generally safe, can rarely lead to pneumothorax.
- Precise anatomical landmark identification and accurate needle placement are critical.
- Even minor deviations in technique may increase the risk of thoracic injury.
Implications:
- Anesthesiologists should maintain vigilance for pneumothorax even with seemingly straightforward blocks.
- Reinforces the importance of meticulous technique and anatomical knowledge in regional anesthesia.
- Suggests a need for further investigation into the specific technical nuances that may predispose to pneumothorax.
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Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History: