Brachial plexus infusion of ropivacaine with patient-controlled supplementation

Abstract

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 axiliary 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.