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Ultrasound-guided brachial plexus nerve block in a patient with a left palmar schwannoma: A case report

Ultrasound-guided brachial plexus block is a common anesthetic procedure used in upper extremity surgery. However, it may not be a suitable option for some patients. PATIENT CONCERNS: A 17-year-old woman with the left palmar schwannoma scheduled for surgical treatment received ultrasound-guided brac...

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Autores principales: Qu, Yan, Yang, Haomin, Wei, Lichun, Su, Guoning
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063262/
https://www.ncbi.nlm.nih.gov/pubmed/37000059
http://dx.doi.org/10.1097/MD.0000000000033440
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author Qu, Yan
Yang, Haomin
Wei, Lichun
Su, Guoning
author_facet Qu, Yan
Yang, Haomin
Wei, Lichun
Su, Guoning
author_sort Qu, Yan
collection PubMed
description Ultrasound-guided brachial plexus block is a common anesthetic procedure used in upper extremity surgery. However, it may not be a suitable option for some patients. PATIENT CONCERNS: A 17-year-old woman with the left palmar schwannoma scheduled for surgical treatment received ultrasound-guided brachial plexus block. The anesthesia modalities of the disease were discussed. DIAGNOSES: Based on the patient’s complaints and clinical appearance, provisional diagnosis of neurofibroma was considered. INTERVENTIONS: In this case, we present a case of ultrasound-guided axillary brachial plexus block used for upper extremity surgery in this patient. It was not easily and painlessly reduced in the surgery, although the visual analogue scale score was 0 and no motor movements of the left arm and palm were observed. The pain was relieved by intravenous injection of 50 mcg remifentanil. OUTCOMES: Immunohistochemically labeled pathological examination confirmed the mass to be a schwannoma. There was no need to apply additional analgesia after surgery, although the patient felt numbness in the left thumb for 3 days follow up. LESSONS: Even if there is painless when skin-cutting after implementation of brachial plexus block, the patient is painful when pulls the nerve around the tumor during excision. It is necessary to give an analgesic drug or anesthetize a single terminal nerve as a supplement for brachial plexus block in patients with schwannoma.
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spelling pubmed-100632622023-03-31 Ultrasound-guided brachial plexus nerve block in a patient with a left palmar schwannoma: A case report Qu, Yan Yang, Haomin Wei, Lichun Su, Guoning Medicine (Baltimore) 3300 Ultrasound-guided brachial plexus block is a common anesthetic procedure used in upper extremity surgery. However, it may not be a suitable option for some patients. PATIENT CONCERNS: A 17-year-old woman with the left palmar schwannoma scheduled for surgical treatment received ultrasound-guided brachial plexus block. The anesthesia modalities of the disease were discussed. DIAGNOSES: Based on the patient’s complaints and clinical appearance, provisional diagnosis of neurofibroma was considered. INTERVENTIONS: In this case, we present a case of ultrasound-guided axillary brachial plexus block used for upper extremity surgery in this patient. It was not easily and painlessly reduced in the surgery, although the visual analogue scale score was 0 and no motor movements of the left arm and palm were observed. The pain was relieved by intravenous injection of 50 mcg remifentanil. OUTCOMES: Immunohistochemically labeled pathological examination confirmed the mass to be a schwannoma. There was no need to apply additional analgesia after surgery, although the patient felt numbness in the left thumb for 3 days follow up. LESSONS: Even if there is painless when skin-cutting after implementation of brachial plexus block, the patient is painful when pulls the nerve around the tumor during excision. It is necessary to give an analgesic drug or anesthetize a single terminal nerve as a supplement for brachial plexus block in patients with schwannoma. Lippincott Williams & Wilkins 2023-03-31 /pmc/articles/PMC10063262/ /pubmed/37000059 http://dx.doi.org/10.1097/MD.0000000000033440 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle 3300
Qu, Yan
Yang, Haomin
Wei, Lichun
Su, Guoning
Ultrasound-guided brachial plexus nerve block in a patient with a left palmar schwannoma: A case report
title Ultrasound-guided brachial plexus nerve block in a patient with a left palmar schwannoma: A case report
title_full Ultrasound-guided brachial plexus nerve block in a patient with a left palmar schwannoma: A case report
title_fullStr Ultrasound-guided brachial plexus nerve block in a patient with a left palmar schwannoma: A case report
title_full_unstemmed Ultrasound-guided brachial plexus nerve block in a patient with a left palmar schwannoma: A case report
title_short Ultrasound-guided brachial plexus nerve block in a patient with a left palmar schwannoma: A case report
title_sort ultrasound-guided brachial plexus nerve block in a patient with a left palmar schwannoma: a case report
topic 3300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063262/
https://www.ncbi.nlm.nih.gov/pubmed/37000059
http://dx.doi.org/10.1097/MD.0000000000033440
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