A Novel Approach to Brachial Plexus Catheter Management: A Brachial Plexus Test Dose for Phrenic Nerve Paralysis and Patient-Controlled, Demand-Only Dosing for a Patient With Extreme Obesity

Adam W. Meier, Shin E. Lin, Neil A. Hanson, David B. Auyong

Research output: Contribution to journalArticlepeer-review

Abstract

A 53-year-old woman with extreme obesity (body mass index = 82 kg/m) presented for an open reduction and internal fixation of the proximal humerus. This report describes the novel management of her continuous brachial plexus catheter in the setting of her comorbidities. Phrenic nerve paralysis from brachial plexus blocks can cause clinically significant dyspnea in obese patients. Brachial plexus catheters can be used effectively for these patients with some modification to routine management. We detail our use of a short-acting chloroprocaine test dose for phrenic paralysis and demand-only dosing to provide effective analgesia while avoiding respiratory complications associated with these blocks.

Original languageEnglish (US)
Pages (from-to)139-142
Number of pages4
JournalA & A case reports
Volume7
Issue number6
DOIs
StatePublished - Sep 15 2016
Externally publishedYes

Fingerprint

Dive into the research topics of 'A Novel Approach to Brachial Plexus Catheter Management: A Brachial Plexus Test Dose for Phrenic Nerve Paralysis and Patient-Controlled, Demand-Only Dosing for a Patient With Extreme Obesity'. Together they form a unique fingerprint.

Cite this