A case of severe ventricular arrhythmias occurring as a complication of nerve-stimulator guided brachial plexus location

Adami, Chiara; Studer, Nina Salouâ

doi:10.1111/vaa.12236

Cited by 13 publications

(7 citation statements)

References 2 publications

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“…Puncture of the pleural space/thorax could also be a potential complication with this technique. 11 Indeed, migration of injectate to the pleural space has been reported with the ABP approach; 6 however, staining of the thoracic cavity was not recorded in this study. Accidental intravenous administration of local anesthetic is a concern with this technique.…”

Section: Discussionmentioning

confidence: 60%

“…Puncture of the pleural space/ thorax could also be a potential complication with this technique. 11 Indeed, migration of injectate to the pleural Figure 2 Dissection of the left brachial plexus in a cat. Muscles of the cervical and cranial thoracic areas were removed and the scapula was retracted to allow visualization of C6, C7, C8 and T1 nerve roots and their branches.…”

Section: Discussionmentioning

confidence: 99%

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Paravertebral brachial plexus blockade in cats: a cadaver study

Evangelista

Monteiro

Doodnaught

et al. 2017

Journal of Feline Medicine and Surgery

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Objectives The aims of this study were to describe the paravertebral brachial plexus (PBP) blockade in cats, and compare the spread of bupivacaine-methylene blue solution (BMS) using two volumes of injection into the PBP. Methods Six cadavers (4.4 ± 1.8 kg) randomly received 0.15 ml/kg (LOW) or 0.2 ml/kg (HIGH) per injection of BMS into the PBP. The first injection was made ventral to the transverse process of the sixth cervical vertebra (nerves C6 and C7) at the emergence of nerve roots. A second injection was performed at the edge of the cranial border of the scapula and directed ventrally towards the first rib (C8 and T1). Cadavers were dissected and the presence of BMS in contact with the nerves (success rate) and length of staining were evaluated for each nerve (C6/C7/C8/T1). Length of target nerves in contact with BMS was measured and <15 mm was considered fair, ⩾15 mm sufficient and >40 mm excessive. Complications (aspiration of blood, staining of pleural space and/or spinal cord) were recorded. Paired t-test, Mann-Whitney U-test and χ test were used for statistical analysis when appropriate ( P <0.05). Results Eleven hemilateral brachial plexuses were injected. Aspiration of blood occurred during one injection. Inadvertent pleural or spinal staining was not observed. Success rates (positive nerve staining) in the LOW and HIGH groups, respectively, were as follows: C6: 83% and 80%; C7: 66% and 100%; C8: 66% and 100%; T1: 50% and 60% ( P >0.05). Median (range) length of nerve staining was 22 mm (15-39 mm) for LOW and 21 mm (13-35 mm) for HIGH ( P >0.05). Excessive nerve staining was not recorded. Conclusions and relevance This study describes the PBP blockade in cats with acceptable nerve staining and minimal complications. Success rate and length of nerve staining were not significantly different between the LOW and HIGH groups.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Paravertebral brachial plexus blockade in cats: a cadaver study

Evangelista

Monteiro

Doodnaught

et al. 2017

Journal of Feline Medicine and Surgery

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“…40 Another reported complication is severe ventral arrhythmia due to the inadvertent introduction of a needle into the chest cavity. 41 In conclusion, although it was not possible to assess the total duration of the blockade, 2% lidocaine at a dose of 5 mg/kg in the brachial plexus anesthesia technique via the supraclavicular approach in black striped capuchin monkeys was efficacious, safe, and easy to perform. The use of the nerve locator as auxiliary in the block was an important facilitator for the success of the technique.…”

Section: Discussionmentioning

confidence: 85%

“…Although the occurrence of pneumothorax is potentially dangerous, its incidence is very low if the technique is performed with a strict protocol, and it has been reported that it can occur in 0.5 to 6% of cases 40 . Another reported complication is severe ventral arrhythmia due to the inadvertent introduction of a needle into the chest cavity 41 …”

Section: Discussionmentioning

confidence: 99%

Assessment of the technique of the anesthetic block of the Brachial Plexus by Supraclavicular approach in Sapajus libidinosus (SPIX, 1823)

Salles

Andrade²,

Cordeiro

et al. 2020

J of Medical Primatology

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Background The aim of study was to evaluate the efficacy of the supraclavicular brachial plexus block technique in Sapajus libidinosus. Methods Were used eight animals, which were sedated, anesthetized, kept under hypnosis, and submitted to plexus block using a neurolocalizer. The physiological parameters, the nociception and response threshold (mA), were evaluated before and after the block. The response to electrical stimulation and cutaneous sensitivity were evaluated. The groups were compared by the Tukey or Friedman test at 5%. Results The technique promoted blockage of the plexus, and movement of the thoracic limb in response to electrical stimulation decreased after 10 minutes. The applied milliampere increased after 5 minutes. The cutaneous sensitivity reflex decreased. The average time of return of spontaneous limb movement exceeded 50 minutes. Conclusions The use of 5mg/kg of lidocaine 2% promoted loss of cutaneous sensitivity and limb muscle relaxation during the evaluation period.

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“…Regional anesthesia is well-described and widely used in veterinary medicine in order to control stress response under general anesthesia, improve perioperative analgesia, reduce opioids administration together with their related side effects, and promote earlier recovery from anesthesia (1,2). On the other hand, potential serious complications such as direct trauma to neurovascular structures or ventricular arrhythmias (3,4) are also reported. Regional blocks were originally performed, blindly, potentially limiting their success rate (5).…”

Section: Introductionmentioning

confidence: 99%

Case Report: Ultrasound Sciatic and Saphenous Nerve Blocks for Tibial Malunion Surgical Correction in a Pediatric African Leopard (Panthera pardus)

et al. 2020

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Little information is available regarding ultrasound-guided locoregional anesthesia in non-domestic species. Locoregional techniques have been shown to reduce intraoperative anesthetic requirements and provide postoperative pain relief. Decreasing dosage of general anesthetics allows more stable cardiopulmonary function during anesthesia and reduces the probability of side effects. An 11-week-old African leopard (Panthera pardus) was referred for treatment of a malunion angular limb deformity secondary to a tibial and fibular fracture. The animal was scheduled to undergo angular correction of the tibia via closing wedge osteotomy and fixation with a locking plate system. Following preanesthetic medication and induction of general anesthesia, a saphenous nerve block (ropivacaine 0.5%; 0.15 ml/kg) was performed under ultrasound guidance and a sciatic nerve block (ropivacaine 0.5%; 0.15 ml/kg) was performed using ultrasound and a peripheral nerve stimulator. Intraoperative anesthetic plane was considered light, yet no abrupt cardiocirculatory changes were seen, nor was rescue analgesia required. This case report suggests that sciatic and saphenous blockade could therefore be recommended as part of a multimodal plan of analgesia for orthopedic surgeries in pediatric exotic felids.

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A case of severe ventricular arrhythmias occurring as a complication of nerve-stimulator guided brachial plexus location

Cited by 13 publications

References 2 publications

Paravertebral brachial plexus blockade in cats: a cadaver study

Paravertebral brachial plexus blockade in cats: a cadaver study

Assessment of the technique of the anesthetic block of the Brachial Plexus by Supraclavicular approach in Sapajus libidinosus (SPIX, 1823)

Case Report: Ultrasound Sciatic and Saphenous Nerve Blocks for Tibial Malunion Surgical Correction in a Pediatric African Leopard (Panthera pardus)

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