Peripheral Nerve Block with Infraclavicular Block in Patient with Prior History of Cerebrovascular Accident: A Case Report

Brachial plexus block via infraclavicular block using perineural local anesthesia for upper extremity surgery results in superior analgesia compared with the axillary or interscalene approach. Neurological disabilities, associated comorbidities, and the effects of both anesthesia and surgery make patients with a history of cerebrovascular accident (CVA) more susceptible to perioperative complications. An Indonesian man, 56 years-old, presented with vulnus schizum of the left wrist extensor zone VIII and malunion of the middle third of the left clavicle. The patient had a history of CVA 3 years ago. Debridement, exploration, tenorrhaphy when needed, and primary hecting were scheduled using peripheral nerve block anesthesia with infraclavicular block. The patient was stable post-surgery without any edema or complicated surgical wound. Experts recommend combining two modalities, such as ultrasound and nerve stimulator, to reduce the chances of complications. Peripheral nerve blocks with infraclavicular block are safe for patients with a history of CVA. Peripheral nerve blocks with the infraclavicular block are recommended in patients with traumatic hand injury with a history of CVA.