Isolated Musculocutaneous Nerve Palsy Following Supraclavicular Nerve Block: A Case Report

The supraclavicular (SC) nerve block is a procedure utilized by anesthesiologists with the goal of providing analgesia to the upper extremity at and below the shoulder. We present a case report of an SC continuous peripheral nerve block (CPNB) complicated by isolated musculocutaneous nerve palsy despite cessation of infusion of local anesthetic.

Patient was a 39-year-old woman with chronic ischemic left-hand pain for which an SC CPNB was placed. Following sympathectomy of the radial and ulnar digital arteries, she reported inability to flex/extend her elbow or shoulder; motor function and sensation were otherwise intact. Following discontinuation of the CPNB, the patient regained sensation and motor function in her left upper extremity.

This isolated palsy may have been due to an entrapment or compression injury from the catheter itself. This case report demonstrates a potential complication of SC CPNB that had not been previously reported in the literature.