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LETTERS TO THE EDITOR

Bilateral Brachial Plexus Block Versus Segmental Epidural Anesthesia

Department of Anesthesia, Ministry of Health, Menemen State Hospital, Izmir, Turkey

To the Editor:

In the case report by Franco et al. (1) on bilateral brachial plexus block procedures, I believe that two points have not been considered:

a) Perhaps an injection with a 22-gauge needle without a local anesthetic infiltration into skin in a region where there is no guarantee of injecting the needle at the desired location with a single injection technique should not be made.

b) A concurrent injection of 53 mL 1% mepivacaine in a critical case like this is a dose that cannot be undermined.

A regional technique to be performed through the placement of an epidural catheter appropriate for the innervation of the regions to be operated in both of the upper extremities might have served as an alternative option to this approach. Thus, it would have been possible to avoid such large doses of local anesthesia to administer additional doses in case of a prolonged operation and to gain more effective postoperative analgesia. Lastly, the rate of a successful segmental epidural anesthesia is more frequent than a bilateral brachial plexus blocking technique.

Footnotes

Dr. Franco does not wish to respond.

Reference

1. Franco CD, Salahuddin Z, Rafizad A. Bilateral brachial plexus block. Anesth Analg 2004; 98: 518–20.[Abstract/Free Full Text]

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