Stimulator-Guided Supraclavicular Block as an Anesthetic Option for Above-Elbow Amputation in an Infant

Abstract

The supraclavicular block is effective in providing surgical anesthesia for upper limb surgery. The safety profile is improved with the use of a nerve stimulator to locate the brachial plexus. Above‑elbow amputation in infants is commonly done under general anesthesia, however, the presence of certain comorbid conditions may increase the risk of mortality. We report the use of a nerve stimulator‑guided supraclavicular block with sedation, to carry out transhumeral amputation for an 11‑week‑old female infant who had gangrene of her left forearm. The subclavian perivascular approach was used to perform the block. A mixture of 0.5% bupivacaine and 2% lidocaine in adrenaline was administered to achieve surgical anesthesia. The onset of the block was 5 min. A total of 2 mg of midazolam was used for sedation. The infant had a successful block. There was no block‑related complication. We suggest that nerve stimulator‑guided supraclavicular block in infants is feasible and safe.

Keywords: Amputation, nerve stimulator, supraclavicular block, surgical anesthesia