Background and Aims Continuous brachial plexus block (CBPB) with local anaesthetic is useful for long surgical operations on upper extremity. CBPC improve tissue perfusion after replantation surgery of the extremity by decreasing vasospasm, relieving pain, and promoting collateral circulation. In reconstructive surgery is particularly important because sympathetic blockade of the vessels provides increased blood flow to the injured extremity, which increases the success rate of the surgery.^1,2

Methods We present a case of a 51-year-old man, ASA 2, who had combined anaesthetic technique with continuous supraclavicular block of the brachial plexus to prevent postoperative pain and maintain extended vasodilatation.

The procedure was successfully completed under combined anesthesia.

Results In the reported case, CBPB was effective providing the best analgesia during the postoperative period and preventing the development of vasospasm in the digital arteries of the re-implanted digit and improving graft survival. The patient had a satisfactory evolution during the postoperative period, with adequate analgesia. No complications were reported.

Conclusions Microsurgical operation of the hand is a common procedure of reconstructive surgery. CPPB offers numerous advantages in terms of the best graft perfusion and was found to be effective in both sympathetic blockade and postoperative pain management. ^1–4