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Upper limb sympathetic blockade following intercostal nerve blocks.

G Purcell-Jones¹, H M Speedy, D M Justins

¹St Thomas' Hospital, London.

|September 1, 1987

Summary

A case study details a temporary sympathetic nerve block affecting the arm after intercostal nerve injections. The study discusses potential causes for this rare complication.

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Area of Science:

Anesthesiology
Neurology
Pain Management

Background:

Percutaneous intercostal nerve injections are utilized for thoracic pain management.
Potential complications include local anesthetic systemic toxicity and neural injury.

Observation:

A patient experienced a transient sympathetic block of the arm post-procedure.
Symptoms included ipsilateral facial sweating, miosis, and ptosis.

Findings:

The sympathetic block was attributed to the spread of local anesthetic to the paravertebral sympathetic chain.
The condition resolved spontaneously within hours.

Implications:

This case highlights the importance of recognizing and managing rare neurological complications of intercostal nerve blocks.
Awareness of potential sympathetic chain involvement can guide anesthetic technique and patient monitoring.

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