Hypercarbia Induced Severe Bronchospasm and Unconsciousness Following Supraclavicular Block

Abstract

Though the popularity of brachial plexus block for upper limb surgery is well known fact, but, one must not forget the complications associated with it. Herein, we report a middle aged obese female with fracture olecranon and proximal end of radius was posted for tension band wiring of olecranon process under ultrasound guided supraclavicular brachial plexus block. She was a known case of chronic obstructive pulmonary disease (COPD), with severe lung fibrosis and collapse, pleural thickening and mediastinal shift to the same side where she had to be operated. After repeated referral for optimization to tuberculosis and respiratory diseases she was posted for surgery after explaining the high risk involved to the patient. Following completion of procedure, she turned supine from lateral decubitus position, found unconscious and tachypnoeic. On auscultation, there was severe bronchospasm/silent chest; was immediately intubated and managed with difficulty.