Effect of Arm Positioning on Entrapment of Infraclavicular Nerve Block Catheter

Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. We describe a case of infraclavicular brachial plexus catheter entrapment related to differences in arm positioning during catheter placement and removal. Written authorization to obtain, use, and disclose information and images was obtained from the patient.

[1]  S. Byram,et al.  Noninvasive removal of an entrapped supraclavicular catheter. , 2012, Journal of clinical anesthesia.

[2]  M. LaBan,et al.  Clavicle-Induced Narrowing of the Thoracic Outlet during Shoulder Abduction as Imaged by Computed Tomographic Angiography and Enhanced by Three-Dimensional Reformation , 2011, American journal of physical medicine & rehabilitation.

[3]  R. McCarthy,et al.  Removal of a knotted stimulating femoral nerve catheter using a saline bolus injection , 2010, Local and regional anesthesia.

[4]  J. Benonis,et al.  The Houdini Clavicle: Arm Abduction and Needle Insertion Site Adjustment Improves Needle Visibility for the Infraclavicular Nerve Block , 2010, Regional Anesthesia & Pain Medicine.

[5]  X. Bargalló,et al.  The Influence of Arm Abduction on the Anatomic Relations of Infraclavicular Brachial Plexus: An Ultrasound Study , 2009, Anesthesia and analgesia.

[6]  K. Chin,et al.  Perforation of a Pajunk Stimulating Catheter After Traction-Induced Damage , 2006, Regional Anesthesia & Pain Medicine.

[7]  P. Bigeleisen,et al.  A comparison of two techniques for ultrasound guided infraclavicular block. , 2006, British journal of anaesthesia.

[8]  Paula M Ludewig,et al.  Three-dimensional clavicular motion during arm elevation: reliability and descriptive data. , 2004, The Journal of orthopaedic and sports physical therapy.

[9]  P. Ludewig,et al.  Three-Dimensional Clavicular Motion during Arm Elevation , 2004 .

[10]  C. R. Goucke,et al.  Shearing of a peripheral nerve catheter. , 2002, Anesthesia and analgesia.

[11]  V. Karuparthy,et al.  An Entrapped Epidural Catheter in a Postpartum Patient , 1998, Regional Anesthesia & Pain Medicine.