Low-concentration, continuous brachial plexus block in the management of Purple Glove Syndrome: a case report
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Updated: Jun 15, 2026

Methods for In Vivo Biomechanical Testing on Brachial Plexus in Neonatal Piglets
Published on: December 19, 2019
Georgene Singh1, Verghese T Cherian, Binu P Thomas
1Department of Anaesthesiology, Christian Medical College, Vellore 632 004, Tamil Nadu, India. georgenesingh@gmail.com.
Introduction:
Purple Glove Syndrome is a devastating complication of intravenous phenytoin administration. Adequate analgesia and preservation of limb movement for physiotherapy are the two essential components of management.
Case Presentation:
A 26-year-old Tamil woman from India developed Purple Glove Syndrome after intravenous administration of phenytoin. She was managed conservatively by limb elevation, physiotherapy and oral antibiotics. A 20G intravenous cannula was inserted into the sheath of her brachial plexus and a continuous infusion of bupivacaine at a low concentration (0.1%) with fentanyl (2 mug/ml) at a rate of 1 to 2 ml/hr was given. She had adequate analgesia with preserved motor function which helped in physiotherapy and functional recovery of the hand in a month.
Conclusion:
A continuous blockade of the brachial plexus with a low concentration of bupivacaine and fentanyl helps to alleviate the vasospasm and the pain while preserving the motor function for the patient to perform active movements of the finger and hand.
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