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Pneumothorax After Ultrasound-Guided Supraclavicular Block: Presenting Features, Risk, and Related Training
  1. Daniel J. Abell, MBChB, FRCA* and
  2. Michael J. Barrington, PhD, MBBS, FANZCA*,
  1. *Department of Anaesthesia, St Vincent’s Hospital, Melbourne
  2. Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
  1. Address correspondence to: Michael J. Barrington, PhD, MBBS, FANZCA, St. Vincent’s Hospital, 41 Victoria Parade, Fitzroy, Melbourne, Victoria 3065, Australia (e-mail: michaelbarrington84{at}gmail.com).

Abstract

Objective Presenting features and estimate of risk of pneumothorax after ultrasound-guided supraclavicular block are discussed, along with related training strategies.

Case Report We describe a case of a patient with pneumothorax after an ultrasound-guided supraclavicular brachial plexus block for hand surgery. The delayed onset of pain initially on the nonoperative side combined with the absence of respiratory symptoms delayed recognition of the pneumothorax.

Conclusions We estimate the risk of pneumothorax to be 0.4 per 1000 after ultrasound-guided supraclavicular block. We recommend specific training strategies for needle visualization for this technique to reduce the risk of pneumothorax.

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Footnotes

  • The authors declare no conflict of interest.

    This case was presented in poster format at the Australian Society of Anaesthetists, National Scientific Congress, Sydney, on September 2011.

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