91 Brachial plexus block can reduce the complica- tions caused by side effects such as difficulty in airway management, retching and vomiting. It al- so has convenient advantages including post- operative pain management. The technique has thus been performed frequently for surgeries on the upper extremities. The approach may differ depending on the sur- gical site. Specific examples include interscalene block, supraclavicular block, subclavicular, axil- lary block, etc. The supraclavicular block is widely used as an- esthesia for surgeries of the elbow, lower arm, and hand areas because it ensures a precise and quick nerve block even with a relatively low dose of local anesthetic. 1 However, complications may occur. Approximately 0.5% to 6% cases of pneumothorax have been reported. Phrenic nerve block (40%−60%) and Horner's Syndrome, neuropathy, etc. may also occur. Horner's Syndrome is a symptom caused by an abnormality of the sympathetic nervous pathway (oculosympathetic pathway) distributed at and around the eyes. Its clinical features include eyelid ptosis, stenocoriasis, and facial hyphidrosis, and may be classified as central, preganglionic or postganglionic Horner's Syndrome according to the above position. 2 The author experienced Horner's Syndrome, Kosin Medical Journal 2018;33:91-95. https://doi.org/10.7180/kmj.2018.33.1.91 KMJ Case Report Unilateral Horner`s Syndrome following supraclavicular brachial plexus block Dawoon Oh Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Gyeonggi-do, Korea Supraclavicular brachial plexus block, due to its wide range of indications, is the most widely practiced procedure in anesthesiology. We experienced the case of a 45-year-old female patient who developed unilateral Horner's Syndrome after the use of supraclavicular brachial plexus block. The patient recovered spontaneousl y from the Horner's syndrome after 2 hours. If Horner's syndrome should occur, its etiology will need to be assessed. It is also important to assure the patient they will recover from the complication within a year. Key Words: Horner's Syndrome, Supraclavicular Block Corresponding Author: Dawoon Oh, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, Korea Tel: +82-31-8086-2029 Fax: +82-31-8086-2029 E-mail: [email protected]Received: Revised: Accepted: May. 30, 2017 Jul. 18, 2017 Jul. 31, 2017 Articles published in Kosin Medical Journal are open-access, distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Corresponding Author: Dawoon Oh, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, Korea Tel: +82-31-8086-2029 Fax: +82-31-8086-2029 E-mail: [email protected]Received: Revised: Accepted: May. 30, 2017 Jul. 18, 2017 Jul. 31, 2017
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91
Brachial plexus block can reduce the complica-
tions caused by side effects such as difficulty in
airway management, retching and vomiting. It al-
so has convenient advantages including post-
operative pain management. The technique has
thus been performed frequently for surgeries on
the upper extremities.
The approach may differ depending on the sur-
gical site. Specific examples include interscalene
around the eyes. Its clinical features include eyelid
ptosis, stenocoriasis, and facial hyphidrosis, and
may be classified as central, preganglionic or
postganglionic Horner's Syndrome according to
the above position.2
The author experienced Horner's Syndrome,
Kosin Medical Journal 2018;33:91-95.https://doi.org/10.7180/kmj.2018.33.1.91 KMJ
Case Report
Unilateral Horner`s Syndrome following supraclavicular brachial plexus block
Dawoon Oh Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Gyeonggi-do, Korea
Supraclavicular brachial plexus block, due to its wide range of indications, is the most widely practiced procedure in anesthesiology. We experienced the case of a 45-year-old female patient who developed unilateral
Horner's Syndrome after the use of supraclavicular brachial plexus block. The patient recovered spontaneously
from the Horner's syndrome after 2 hours. If Horner's syndrome should occur, its etiology will need to be assessed. It is also important to assure the patient they will recover from the complication within a year.
Corresponding Author: Dawoon Oh, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, KoreaTel: +82-31-8086-2029 Fax: +82-31-8086-2029 E-mail: [email protected]
Received:Revised:Accepted:
May. 30, 2017Jul. 18, 2017Jul. 31, 2017
Articles published in Kosin Medical Journal are open-access, distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding Author: Dawoon Oh, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, KoreaTel: +82-31-8086-2029 Fax: +82-31-8086-2029 E-mail: [email protected]
Received:Revised:Accepted:
May. 30, 2017Jul. 18, 2017Jul. 31, 2017
Kosin Medical Journal 2018;33:91-95.
92
which occurred after the brachial plexus block
using the supraclavicular block was performed.
The author reports the experience with consid-
eration through literature.
CASE
The patient is a 45-year-old woman who is
162 cm tall and weighs 59 kg. About 3 weeks
ago, she was diagnosed with Lt. hand 4th
Metacarpophalangeal Fx. after she slipped and
struck her hand. The patient was admitted to
the orthopedic surgery ward to undergo correc-
tive osteotomy and pinning.
There were no exceptional cases of health con-
ditions or disease in her medical history. The pre-
operative ECG, chest radiography, and blood test
were performed, and the results were all normal.
The patient underwent the ultrasound-guided
supraclavicular block while being monitored for
vital signs. She received a series of 2 injections,
1% lidocaine (11 ml in total) and 0.75% ropivacaine