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  • Regional to the Rescue! Axillary Brachial Plexus Nerve Block Facilitates Removal of Entrapped Transradial Catheter Placed for Cardiac Catheterization

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Regional Anesthesia and Acute Pain: Case Report
Regional to the Rescue! Axillary Brachial Plexus Nerve Block Facilitates Removal of Entrapped Transradial Catheter Placed for Cardiac Catheterization
  1. Brian M. Fitzgerald, MD,
  2. Lee A. Babbel, DO,
  3. Ferdinand K. Bacomo, DO and
  4. Sandeep T. Dhanjal, MD
  1. Department of Anesthesiology, Brooke Army Medical Center, Fort Sam Houston, TX
  1. correspondence: Brian M. Fitzgerald, MD, Department of Anesthesiology, Brooke Army Medical Center, 3851 Roger Brooke Dr, Fort Sam Houston, TX 78234 (e-mail: brian.m.fitzgerald.mil{at}mail.mil).

Abstract

Objective Our objective was to describe the first reported use of an axillary brachial plexus block to treat the entrapment of a transradial artery catheter due to vasospasm.

Case Report A 42-year-old man undergoing transradial arterial cardiac catheterization suffered arterial vasospasm causing the catheter to become entrapped and refractory to conservative (warm compresses) and standard pharmacologic interventions (intracatheter verapamil, intravenous infusions of nitroglycerin and nicardipine, and subcutaneous lidocaine and topical nitroglycerin). Anesthesia was consulted, and attempts at catheter removal under monitored anesthesia and general anesthesia failed. Finally, in order to avoid surgical intervention, an ultrasound-guided axillary brachial plexus block with mepivacaine was performed, resulting in easy removal of the catheter.

Conclusions Axillary brachial plexus nerve blocks are an effective, efficient, and safe intervention with a wide range of indications. This case report demonstrates that an axillary nerve block can be used to treat the entrapment of a transradial artery catheter due to vasospasm.

https://doi.org/10.1097/AAP.0000000000000595

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    Footnotes

    • Institution where work is attributed: Brooke Army Medical Center.

      The authors declare no conflict of interest.

      The view(s) expressed herein are those of the author and do not reflect the official policy or position of Brooke Army Medical Center, the US Air Force Medical Service, the US Air Force Office of the Surgeon General, the Department of the Air Force, Department of Defense, or the United States.