Yeungnam Univ J Med.  2015 Jun;32(1):22-25. 10.12701/yujm.2015.32.1.22.

Exacerbation of spasticity in ipsilateral shoulder after right brachial plexus block in a patient with right hemiplegia

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea. apsj0718@naver.com

Abstract

Spasticity is a common impairment in patients with central nervous system disease. Clinical observation has demonstrated that spasticity can be aggravated by various factors such as emotional state as well as noxious stimuli. A 51-year-old male patient was scheduled for arteriovenous fistula surgery. He had right hemiplegia including motor weakness and spasticity. It was decided that the surgery would be performed under an axillary brachial plexus block (BPB). He appeared nervous when blockade was terminated. The spasticity of the right shoulder increased after ipsilateral BPB. However, when we administered sedative drugs and performed interscalene BPB 2 days later, spasticity did not occur. Exacerbation of spasticity might be evoked by an anxious emotional state. Thus, it seems to be good to consider removing of anxiety and using an appropriate approach when it is tried to perform nerve blocks in individuals with spasticity.

Keyword

Spasticity; Anxiety; Nerve block

MeSH Terms

Anxiety
Arteriovenous Fistula
Brachial Plexus*
Central Nervous System
Hemiplegia*
Humans
Male
Middle Aged
Muscle Spasticity*
Nerve Block
Shoulder*
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