Ultrasound-Guided Bilateral Infraclavicular Brachial Plexus Blockade for Bilateral Distal Radius Fracture Surgery: Case Report

Unilateral brachial plexus blockade causes efficient analgesia and anesthesia so it is frequently used in upper extremity surgery without major complications. However, bilateral brachial plexus blockade has some disadvantages such as systemic local anesthetic toxicity, pneumothorax and phrenic nerve paralysis. Thus bilateral brachial plexus blockade is seldom used in clinical practice. Here, we are presenting a case with bilateral radial head fracture that was operated under bilateral ultrasound guided infraclavicular blockade. The dosage of the local anesthesia was reduced and a total of 15 ml of local anesthetic (10 ml 5%  levobupivacaine+ 5 ml  2 %lidocaine) for each extremity. The lateral sagittal infraclavicular blockade was successfully performed under ultrasound guidance without any complication. Total dosage local anesthetic should be carefully arranged during bilateral plexus blockades even if the blockade is performed under ultrasound guidance. It must be kept in mind that, although ultrasound guidance increases the success rate of the blockade it never eliminates  risks of the complication