Feasibility and safety of brachial plexus blocks in patients with cervical spinal cord injury undergoing upper extremity surgery

Deeble C, To L, Mariano ER, Fox P, Curtin C, Kou A, Hunter OO

Introduction:

Upper extremity reconstructive surgeries can improve function in cervical spinal cord injury (SCI) patients, but this population may be considered high perioperative risk. Continuous peripheral nerve block (CPNB) may offer benefits for these patients despite preexisting neurologic symptoms.

 

Methods:

A retrospective chart review was completed to evaluate CPNB-related neurologic symptoms and postsurgical opioid use from the day of surgery to postoperative day (POD) 7 and the first bowel movement after surgery in SCI patients having upper extremity surgery with a brachial plexus CPNB.

 

Results:

15 patients were included in our analysis (Online Table 1). No patient had new neurologic symptoms following CPNB removal. One patient’s CPNB was removed POD 2 for shortness of breath. Most patients had a bowel movement by POD 1 (Table 2). Most patients returned to baseline daily opioid use or weaned off opioids by POD 3 (Figure 1).

 

Discussion:

Brachial plexus CPNB may be safe in patients with cervical SCI and well-tolerated for 3-6 days.