Article Text

Download PDFPDF

#35911 A case report: the use of ultrasound guided peripheral nerve block for humerus surgery in a patient with fixed neck deformity
  1. Aarushi Jain1 and
  2. Balavenkatasubramanian Jagannathan2
  1. 1Department of Anaesthesia, Vardhman Trauma and laparoscopy Centre, Muzaffarnagar, India
  2. 2Department of Anaesthesia, Ganga Medical Centre and Hospital Pvt Limited , Coimbatore , India


Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)

Background and Aims Upper extremity surgeries are generally performed under general anaesthesia, regional anaesthesia or a combination of both. However, with the advent of newer techniques of administering peripheral nerve blocks using ultrasound, the need and use of general anaesthesia in upper limb surgeries is declining, where these facilities are available. In patients with anticipated difficult airway and medical comorbidities, this state of art technique proves to be even more safe, precise and reliable as a mode of anaesthesia.

Methods This case study includes a 62 year male patient with a fracture of shaft of humerus requiring open reduction and internal fixation. He was a chronic smoker and alcoholic. On airway examination, he was found to have no neck movements due to trauma to cervical spine during childhood. We proceeded with ultrasound guided inter scalene and supraclavicular block with a total of 20 ml of 0.75% ropivacaine and 4mg of dexamethasone. The difficult airway cart and awake fibre optic intubation equipments were kept as standby.

Abstract #35911 Figure 1

Preoperative X-ray

Abstract #35911 Figure 2

Postoperative X-ray

Abstract #35911 Figure 3

Ultrasound scan of the interscalene groove in neutral position of the neck

Results The surgery was completed solely under the nerve block without requiring any additional analgesic or rescue anaesthesia. The patient remained pain free in the postoperative period and was discharged the next day.

Conclusions Ultrasound guided regional anaesthesia proves to be a boon in high risk upper limb trauma cases. It circumvents the need of airway manipulation in anticipated difficult airway cases and also eliminates the cardiopulmonary effects of general anaesthesia in medically compromised patients.

  • Ultrasound
  • general anaesthesia
  • regional anaesthesia
  • peripheral nerve block

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.