Ann Rehabil Med.  2014 Apr;38(2):282-285.

Median Nerve Injury Caused by Brachial Plexus Block for Carpal Tunnel Release Surgery

• Kim TH
• Kim CK
• Lee KD
• Koo JH
• Song SH

Abstract

Carpal tunnel release is required to treat patients with severe carpal tunnel syndrome. The regional anesthesia of the upper limb by brachial plexus block (BPB) may be a good alternative to general anesthesia for carpal tunnel release surgery, because it results in less complications. However, the regional anesthesia still has various side effects, such as hematoma, infection, and peripheral neuropathy. We hereby report a rare case of median nerve injury caused by BPB for carpal tunnel release.

Keyword

Carpal tunnel syndrome; Brachial plexus

MeSH Terms

Anesthesia, Conduction
Anesthesia, General
Brachial Plexus*
Carpal Tunnel Syndrome
Hematoma
Humans
Median Nerve*
Peripheral Nervous System Diseases
Upper Extremity

Reference

1. Wilson JK, Sevier TL. A review of treatment for carpal tunnel syndrome. Disabil Rehabil. 2003; 25:113–119. PMID: 12648000.

2. Kuschner SH, Brien WW, Johnson D, Gellman H. Complications associated with carpal tunnel release. Orthop Rev. 1991; 20:346–352. PMID: 2041657.

3. Horlocker TT, Kufner RP, Bishop AT, Maxson PM, Schroeder DR. The risk of persistent paresthesia is not increased with repeated axillary block. Anesth Analg. 1999; 88:382–387. PMID: 9972761.

4. Selander D, Edshage S, Wolff T. Paresthesiae or no paresthesiae? Nerve lesions after axillary blocks. Acta Anaesthesiol Scand. 1979; 23:27–33. PMID: 425811.

5. Tsao BE, Wilbourn AJ. Infraclavicular brachial plexus injury following axillary regional block. Muscle Nerve. 2004; 30:44–48. PMID: 15221877.

6. Urban MK, Urquhart B. Evaluation of brachial plexus anesthesia for upper extremity surgery. Reg Anesth. 1994; 19:175–182. PMID: 7999652.

7. Hartung HJ, Rupprecht A. The axillary brachial plexus block: a study of 178 patients. Reg Anaesth. 1989; 12:21–24. PMID: 2919235.

8. Ben-David B, Stahl S. Prognosis of intraoperative brachial plexus injury: a review of 22 cases. Br J Anaesth. 1997; 79:440–445. PMID: 9389259.

9. Armstrong MB, Villalobos RE. Surgical treatment of carpal tunnel syndrome. Phys Med Rehabil Clin N Am. 1997; 8:529–539.

10. Palmer AK, Toivonen DA. Complications of endoscopic and open carpal tunnel release. J Hand Surg Am. 1999; 24:561–565. PMID: 10357536.