Ultrasound-guided bilateral infraclavicular block: case report

Abstract

Bilateral brachial plexus block is rarely performed due to the risk of systemic toxicity of local anesthetics. Therefore, general anesthesia is generally preferred in bilateral extremity operations. However, usage of ultrasound allows easy visualization of the structures of the vessels and the nerves. In this case report, we present a 28-year-old man who was scheduled for bilateral hand surgery with ultrasound-guided bilateral infraclavicular block after he refused general anesthesia. After visualization of the axillary artery and the cords of the brachial plexus with linear ultrasound probe, the mixture of local anesthetics, which was prepared as 20 ml for each extremity (10 ml 2% lidocaine (with 5 μg. ml-1 adrenaline) + 10 ml 7.5% levobupivacaine), was injected using triple injection method. During block performance, no complication developed. In conclusion, we think that infraclavicular block can be safely performed bilaterally with ultrasound guidance, which allows a reduction in the dose of local anesthetic.