Dual Brachial Plexus Block for Distal Biceps Repair: A Case Report

A 35-year-old male presented with a right distal biceps tear. The patient was scheduled for a distal biceps repair at an ambulatory surgical center. Given the patient's body mass index of 56.68 kg/m², the surgery center's anesthesiologist recommended the use of a dual brachial plexus regional nerve block to avoid general anesthesia. While the use of dual brachial plexus blocks has been shown to be successful for shoulder procedures, their use in the distal humerus and elbow regions has not been fully established. Under ultrasound guidance, a combination of interscalene and supraclavicular nerve blocks was used as the sole anesthesia in addition to the use of midazolam for light sedation for the length of the procedure. The use of the dual block provided adequate biceps relaxation and anesthesia for a successful distal biceps repair using suture anchor repair. Dual regional blocks may be considered for patients, especially those with multiple comorbidities for whom general anesthesia poses an increased risk of complications, such as deep vein thrombosis, pulmonary embolism, and intraoperative bleeding.