A case with complicated brachial plexus block mistaken for tourniquet paralysis reminding the importance of communication and collaboration in teamwork
Journal Title: International Journal of Medical and Health Sciences - Year 2016, Vol 5, Issue 1
Abstract
Complications may occur even though every precaution is taken to prevent them and physicians can find themselves defending against unfair claims. A 21-year-old man complained of inability to move his elbow, wrist and fingers after he had been operated for his ulna fracture. With the initial assumption of tourniquet palsy as the cause, the patient was not examined thoroughly. The tourniquet is used routinely in operating theatres and most of the few complications seen with its use are usually preventable and often have medicolegal implications. The surgeons were almost to explain the patient and his relatives about this detrimental and unacceptable complication if they did not learned actually anesthetist performed infraclavicular brachial plexus block before administering general anesthesia. Unfortunately it turned out that this was not just a prolonged presentation but also an unexpected complication of the blockade. At three months the fracture united clinically and full neurologic recovery is detected at four months.A prolonged local anesthetic regional nerve blockade can be confused with nerve palsy as an unexpected operation complication. Accurate diagnosis of the situation rests firmly upon the communication and collaboration among surgeons and anesthesiologists and a competently performed physical examination without making any assumptions.
Authors and Affiliations
Ali UTKAN, Anıl AGAR, Kubilay Ugurcan CERİTOGLU, Aydın Arslan, Burak KOCAK
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