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Brachial plexus infusion of ropivacaine with patient-controlled supplementation

From the Department of Anesthesiology and Department of Orthopedics, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.

Address correspondence to: Dr. Peter H.K. Mak. Phone: 852-28555791; Fax: 852-28553384; E-mail: makphk{at}hkstar.com

Purpose: To report the use of continuous brachial plexus analgesia to facilitate physiotherapy

Clinical Features: A 34-yr-old man had contractures of the fingers of his dominant hand following a crush injury in 1996. After several operations, he continued to experience severe pain and disability. In order to facilitate pain-free active and passive physiotherapy, we performed an axillary brachial plexus block. After insertion of a brachial plexus catheter via the axilla, analgesia was continued for a period of one week using a 3 ml•hr^–1 background infusion of ropivacaine 0.2% with the facility for additional patient-controlled 1 ml boluses. Both active and passive physiotherapy was carried out daily for the entire week.

Conclusion: This technique was successful with no major complications and resulted in a marked reduction in pain, with improved range of finger movement and general upper limb function.

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