Color Doppler Ultrasound-guided Axillary Brachial Plexus Block in Patient without Brachial Pulse: A Case Report

Abstract

Color Doppler ultrasound-guided regional block like brachial plexus block lately changed other anesthesia and analgesia practice because of the accuracy and simplicity of practice to view the anatomy of blood vessels and nerves. With color Doppler ultrasound-guided regional block you can follow needle track to nerves and prevent any vessel puncture. It can be the standard for any regional block. The patient was a 64 years Iranian who had diabetes mellitus and hypertension and planned as an urgent right upper limb amputation surgery. Because of the acute exacerbation of COPD due to pneumonia we decided to use regional anesthesia for this patient. On the first physical examination there was no peripheral pulse in patient’s right hand. With ultra-sonographic color Doppler the pulselessness of right hand artery were monitored. With the anatomic and awareness of grey-scaled ultrasonography the nerves and vessels were found. Axillary brachial plexus block with guidance of grey-scaled ultrasonography were done and the surgery was successfully performed and patient transferred to ICU for post operation care after surgery.