Delayed Recovery of Radial Nerve Function after Axillary Block in a Patient Receiving Ipsilateral Ulnar Nerve Transposition Surgery

Abstract

腋神經阻斷術可藉由諸如神經刺激、穿刺腋動脈等方式來達成，但也可能造成神經血 管上的損傷，甚至更為嚴重的併發症。本文報告一名六十八歲的女性病患，在同時接 受神經刺激和穿刺腋動脈而達成的腋神經阻斷術後，上臂產生明顯血腫及瘀青，同時 合併手術同側橈神經功能延遲回復。在此我們建議施行腋神經阻斷術時，勿同時合併 使用神經刺激和穿刺腋動脈方式，以避免可能隨之增加的神經和血管上的損傷。 A 68-year-old female who underwent right ulnar nerve transposition surgery under axillary block (AB) by dualtechnique (paresthesia and axillary artery penetration techniques) developed postoperative wristdrop. Physical examination showed local hematoma formation with ecchymosis at her right axillary region. Both ultrasonography and nerve conduction studies on her brachial plexus revealed neither direct hematoma compression, intra-neural hematoma, nor peripheral neuropathy. Fortunately, she was completely restored to her right hand function 20 h after anesthesia, and was discharged without sequelae 17 days later. In this case, delayed recovery of radial nerve function after AB was suspected and the mechanism which led to this unusualness is discussed.