Total Intravenous Anaesthesia with Propofol and Dexmedetomidine for Brachial Plexus Repair with Intraoperative Neuromuscular Monitoring: A Case Series

Amartya Chaudhuri; Shital Kuttarmare; Pradnya Bhalerao; Neha Kamble

doi:10.18502/aacc.v9i2.12505

Amartya Chaudhuri Department of Anaesthesiology, Byramjee Jeejeebhoy Govt. Medical College, Pune, India.
Shital Kuttarmare Department of Anaesthesiology, Byramjee Jeejeebhoy Govt. Medical College, Pune, India.
Pradnya Bhalerao Department of Anaesthesiology, Byramjee Jeejeebhoy Govt. Medical College, Pune, India.
Neha Kamble Department of Anaesthesiology, Byramjee Jeejeebhoy Govt. Medical College, Pune, India.

DOI: https://doi.org/10.18502/aacc.v9i2.12505

Keywords: Total intravenous anesthesia; Brachial plexus; Neuromuscular monitoring; Propofol; Dexmedetomidine

Abstract

Background: Brachial plexus surgery requires neural repair with the use of intraoperative peripheral nerve stimulation without muscle relaxants.

Methods: Twelve cases were conducted under total intravenous anaesthesia, receiving intravenous propofol, fentanyl and dexmedetomidine infusion. Intraoperative hemodynamic conditions and postoperative functional recovery were assessed.

Results: 9 out of 12 cases were stable while one was in a lighter plane requiring 20 mg propofol and increased dexmedetomidine, two had bradycardia requiring reduced dexmedetomidine infusion. At three months, five cases showed improvement.

Conclusion: Satisfactory conditions were achieved including hemodynamic stability, and muscle-sparing improving prognoses of brachial plexus surgeries.