Role of Ultrasound-Guided Hemidiaphragm Sparing Brachial Plexus Block in the Morbidly Obese Patient

Vinod K; Raj Murugan; Arulmozhi Shanmuga Priya; Richards Sam

doi:10.5812/jcma-151423

Journal of Cellular & Molecular Anesthesia

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https://doi.org/10.22037/jcma.v7i3.38114

Role of Ultrasound-Guided Hemidiaphragm Sparing Brachial Plexus Block in the Morbidly Obese Patient

Author(s):

Vinod K^1,*,

Raj Murugan²,

Arulmozhi Shanmuga Priya¹,

Richards Sam²

1Sree Balaji Medical College And Hospital, Chennai, IndiaCorresponding Author: Krishnagopal Vinod, Professor of Anesthesiology, Sree Balaji Medical College And Hospital, Chennai, IndiaEmail: vinodkrishnagopal@gmail.com

2Sree Balaji Medical College And Hospital, Chennai, India

Journal of Cellular & Molecular Anesthesia:Vol. 7, issue 4; e151423

Published online:May 13, 2022

Article type:Case Report

How to Cite:Vinod KRaj MuruganArulmozhi Shanmuga PriyaRichards SamRole of Ultrasound-Guided Hemidiaphragm Sparing Brachial Plexus Block in the Morbidly Obese Patient.J Cell Mol Anesth.7(4):e151423.https://doi.org/10.22037/jcma.v7i3.38114.

Abstract

Patients with Grade III obesity pose unique challenges to the treating anesthesiologists. The challenges range from difficulty in intravenous cannulation to airway management. Regional anesthesia is advantageous over general anesthesia as it avoids airway manipulation, prevents reduction in functional residual capacity, and provides good postoperative analgesia. Regional anesthesia has its pitfalls like identifying the landmarks accurately and hemi diaphragmatic palsy following brachial plexus block. Hemi diaphragmatic palsy is poorly tolerated in grade III obese patients leading to increased peri-operative morbidity which undermines the advantages of regional over general anesthesia. Ultrasound-guided costoclavicular brachial plexus block(CCBPB) has the benefit of reduced hemi diaphragmatic palsy, avoiding pleural injury, and wider distribution of sensory blockade. Costoclavicular block has been administered to obese patients in the past with great success. We are reporting a successful case of ultrasound-guided costoclavicular brachial plexus block performed in an obese patient with a BMI of 51.56Kg/m2.

Keywords

Obesity

functional residual capacity

brachial plexus block

hemi diaphragmatic palsy

References

1.
References are in the PDF file of the article.

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Author(s):

Vinod K:[PubMed][Scholar]
Raj Murugan:[PubMed][Scholar]
Arulmozhi Shanmuga Priya:[PubMed][Scholar]
Richards Sam:[PubMed][Scholar]