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Background and Aims The case demonstrates that ultrasound-guided nerve block with sedation is a safe and effective alternative to general anesthesia for upper extremity surgery in patients with limited neck mobility due to a halo device. This technique avoids the risks of general anesthesia and potentially reduces costs while keeping patients comfortable throughout the procedure.

Methods A 21-year-old man with a halo device fixing a cervical spine fracture needed surgery for his fractured humerus. Due to the halo device limiting neck movement, regional anesthesia with ultrasound-guided supraclavicular nerve block was chosen. After sedation with midazolam and fentanyl, the doctor injected ropivacaine with ultrasound guidance to numb the arm. Dexmedetomidine was added for continuous sedation. The surgery lasted 2.5 hours, and the patient recovered well with pain medication.

Results This case report shows that ultrasound-guided nerve block with sedation is a safe and effective alternative to general anesthesia for upper extremity surgery. It’s particularly valuable for patients with limited neck mobility, like those wearing a halo device. The patient in this case tolerated the surgery well with minimal sedation, stable vitals, and minimal postoperative discomfort, all controlled with medication

Conclusions Ultrasound-guided supraclavicular nerve block with dexmedetomidine sedation emerged as a safe and effective alternative to general anesthesia for upper extremity surgery in this case. It avoids the risks of general anesthesia for patients with vulnerable cervical fractures. This regional block technique potentially reduces anesthesia costs while providing adequate pain control. Additionally, dexmedetomidine keeps patients comfortable and cooperative during surgery by offering mild sedation and pain relief.