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Peri‐operative brachial plexus injury following self‐positioning for stereotactic radiofrequency ablation
Author(s) -
Hoerner E.,
Bale R.,
Gasteiger L.,
Putzer D.
Publication year - 2019
Publication title -
anaesthesia reports
Language(s) - English
Resource type - Journals
ISSN - 2637-3726
DOI - 10.1002/anr3.12024
Subject(s) - peri , brachial plexus injury , medicine , radiofrequency ablation , ablation , brachial plexus , perioperative , surgery , radiology
Summary A 71‐year‐old woman with a known accessory cervical rib and distinct scoliosis was scheduled for elective, percutaneous stereotactic radiofrequency ablation of a non‐resectable intrahepatic cholangiocellular carcinoma. Patient positioning and fixation using a Bluebag fixation system (Medical Intelligence, Schwabmünchen, Germany) and a dedicated adjustable armrest were customised in the patient while awake. In order to provide safe conditions for mask ventilation and tracheal intubation, the patient was returned to standard supine positioning without changing the position of the armrest. Following the induction of general anaesthesia, the patient's arm was returned to the previously defined position. Upon completion of the procedure and emergence from anaesthesia, the patient immediately reported symptoms of severe brachial plexus damage. Therefore, we suggest that awake positioning according to current recommendations does not completely preclude the possibility of neurologic injury.