Ultrasound-guided bilateral infraclavicular block in a pediatric patient: Case report

Abstract

Bilateral brachial plexus block is not frequently applied due to the risk of local anesthesia toxicity development. Therefore, general anesthesia is often the first choice in patients undergoing bilateral upper extremity surgery. A 14 years old female patient, weighing 42 kg was scheduled for surgery due to post-traumatic bilateral forearm fractures. Anesthesia methods were explained in detail to patient relatives and to the patient. Due to its high quality post-operative analgesia and long duration of effect, bilateral infraclavicular block was agreed to be used. A 15 ml mixture of 0.5% levobupivacaine and 1% lidocaine, under the guidance of ultrasound was injected to each side with lateral sagittal infraclavicular approach using a 22G injection needle. No operational or intra-operative complication was observed and no additional analgesic consumption was required during the 60 minutes operation and until the post-operative 10th hour. As a result, we believe that, ultrasound-guided upper extremity block, even bilateral block can be applied safely in appropriate pediatric cases.