Amitani Ken, Tanioka Satoru, Ishiyama Mika, Nishimura Kazu
From the Departments of Anesthesia.
Neurosurgery, Matsusaka Chuo General Hospital, Matsusaka City, Japan.
A A Pract. 2018 Sep 1;11(5):131-133. doi: 10.1213/XAA.0000000000000761.
We present a 36-year-old female patient who underwent transradial cerebrovascular angiography because of acute putaminal hemorrhage. Catheter entrapment occurred with severe pain in the right upper arm proximal to the elbow. A subclavian artery angiogram by way of a transfemoral crossover catheter revealed severe vasospasm in the axillary artery distal to the branch point between it and the posterior brachial circumflex artery. Diazepam 5 mg intravenously (IV) through a peripheral catheter, lidocaine 0.5% 5 mL injected subcutaneously, and lidocaine 2% 4 mL IV isosorbide dinitrate 2 mg IV through the angiographic crossover catheter failed to relieve the pain and catheter entrapment. An ultrasound-guided supraclavicular brachial plexus block relieved both within 3 minutes. In the past, general anesthesia would have been administered.
