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Anesthesia Journals | Clinical Anesthesia Journals | Pain Medicine Journals | Journal of Clinical Anesthesia and Pain Medicine | Scient Open Access
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Journal of Clinical Anesthesia and Pain Medicine

JCAPM

Aabstract

Case Report

Choreiform Movement on the Same Side after Supraclavicular Brachial Plexus Block under Ultrasonography

Bong Jin Kang, Nayoung Choi

Correspondence Address :

Bong Jin Kang
Professor, Department of Anesthesia and Pain Medicine
College of Medicine
Dankook University, Cheonan City, 31116
Korea
Email: anebjkang@hanmail.net

Received on: June 05, 2018, Accepted on: June 12, 2018, Published on: June 29, 2018

Citation: Bong Jin Kang (2018). Choreiform Movement on the Same Side after Supraclavicular Brachial Plexus Block under Ultrasonography

Copyright: 2018 Bong Jin Kang. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract
A healthy woman without any medical history, developed an irregular involuntary movement disorder of the ipsilateral upper extremity about two hours after injection of mepivacaine (480 mg) for supraclavicular brachial plexus block under ultrasound guidance. Midazolam 2 mg and fentanyl 50 μg were intravenously injected at the time of local infiltration just before the block. After neurological consultation on the movement disorder, it was assessed as a choreiform movement. The physical signs subsided for some time with the administration of midazolam or lorazepam but recurred again. The movement abnormality continued without diminution during voluntary action following verbal command. This involuntary movement decreased gradually and disappeared spontaneously twelve hours after the brachial plexus block without further treatment. Brain magnetic resonance imaging showed no abnormal results. She recovered completely without sequelae. This movement disorder seems to be caused by mechanical injury from using a long-beveled sharp needle. We report on this rare case with some presumable mechanisms.

Keywords: Brachial plexus block, Choreiform movement, Mechanical injury.

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