Right hydrothorax misconceived as atelectasis after left internal jugular vein catheterization: A case report / 대한마취과학회지

Central vein catheterization is a common procedure for monitoring the central venous pressure, securing vascular access, administrating vasoactive drugs and removing air embolisms. However, many complications can occur, such as vessel injury, pneumothorax, hydrothorax, nerve injury, arrhythmia and infection at the insertion site. We encountered an unusual complication of a localized right hydrothorax that was initially misinterpreted as an atelectasis after left internal jugular vein catheterization and right lateral positioning for a left lower lobectomy.

Phrenic nerve palsy following coracoid infraclavicular brachial plexus block / 대한마취과학회지

Various methods of infraclavicular brachial plexus block have been introduced in the past, of which Wilson's coracoid infraclavicular brachial plexus block, a more lateral approach, consequently thought to be easier and safer. While only a few cases of transient ipsilateral phrenic nerve palsy after infraclavicular brachial plexus block have been reported, we describe a rare case of phrenic nerve palsy after Wilson's coracoid infraclavicular brachial plexus block.

Usefulness of ultrasound-guided infraclavicular brachial plexus block: a comparison with nerve stimulation method / 대한마취과학회지

BACKGROUND: Recently, ultrasound guidance in clinical procedures including brachial plexus block has gained popularity. This method has been considered to be an efficient and a useful method with real-time visualization. Many reports have showed the usefulness of ultrasound-guided brachial plexus block. We evaluated the usefulness of ultrasound guidance in infraclavicular brachial plexus block compared with nerve stimulation. METHODS: Thirty patients were randomized into two groups of US group (ultrasound-guided block) and NS group (nerve stimulation). Blocks were performed with mepivacaine 2% and bupivacaine 0.5% with epinephrine 1:200,000 (total volume 40 ml). Block execution time, onset time, success rate, patient's discomfort and complications were measured and statistically evaluated for the comparison. RESULTS: Block execution time were 88.3 +/- 48.1 sec in US group and 172.7 +/- 103.1 sec in group NS, respectively (P = 0.017). Onset time were 16.0 +/- 6.9 min and 17.7 +/- 7.8 min (P = 0.434). Success rates were 93.3% and 80.0% (P = 0.283). Patient's discomfort was not significantly different. Pain in patients with fractured arm was significantly lower in US group (P = 0.004). CONCLUSIONS: An ultrasound-guided infraclavicular brachial plexus block is useful with less time consumption and less discomfort in patients with fracture of arm. Success rate and onset time were acceptable.