United Brachial Plexus Network, Inc.

I am a 32 yr LOBPI, and I have a 75-80 degree contracture at my elbow. I have found(thanks to Dr. Kozin)a elbow specialist at the Mayo Clinic in Minnesota(Dr. O'Driscoll). My concern is that his surgery requires a brachial plexus block for the anesthetic. This is suppose to keep my arm numb so that movement of my elbow joint can be continual without pain after surgeryy. However since my contracture was due to a brachial plexus injury does anyone have any information whether this procedure should be performed or not. It bothers me that since my injury is brachial plexus related I do not feel comfortable with this procedure for anesthetic, and therefore I am looking for anyone who has suggestions so I can bring this to the attention of my surgeon at time of surgery. My surgeon is not a brachial plexus specialist and so I do not know if he would be aware of the seriouness of that type of block for my condition. Thank you

EEK! This doesn't sound good to me. I would be VERY hesitant to allow this....nah - I'm just pretty sure I couldn't allow it. Not unless I was presented with a very good PROVEN reason to do it. Why mess with an already injured plexus? Scary!
Jaime

Do a lot of research. Make sure the doctor who would do this knows EVERYTHING about your BPI. Make sure he can guarantee you that nothing would get worse with your injury. If he cannot give you a guarantee, then I wouldnt do it.

I am totally in sympathy with what you're saying-I am scheduled for amputation (when the NZ health service gets round to it) and the ortho said a brachial plexus block for anaesthesia would reduce phantom limb pain. I have looked into it but feel that is not applicable in my case as I have already developed phantom limb pain. Like you I am very wary of any kind of interference in the bpi area-even the lightest touch in my shoulder/neck area sets off pain and I feel there is damage in there these doctors can't even begin to imagine! Needles in there too? No way!

My gut feeling says stay away from a nerve block in that area but that's all it is, an instinctive feeling. My own research has failed to find anything other than stuff about very newly injured people which I feel is not applicable to either you or me.
The Mayo clinic bpi team are probably the most experienced with adult bpi in the USA, maybe get your doctor to ask them about this.
If you don't get the reassurance you need, tell the doctors you won't do it.
Just my 2 cents :0)
Jen NZ

Nicole:
I would call around to some of the other bpi docs, you can find them on the Medical Resource page of this website. Explain your problem, and the proposed solution. Before I would let anyone "block" my daughter's plexus, I would have heard volumes about it from many doctors.

I think this warrants more research. If I were you, I would get more opinions.

good luck,
claudia

I would be very concerned that the typical brachial plexus block won't completely *work* because your nerves have been damaged and everything in the area is probably not "typical". The last thing you'd want is to have breakthrough sensation in the middle of the surgery!!! Also, if you have neuromas/etc. I would be concerned about how the anesthetic affects them.

I agree with the others... unless this dr. has a really clear understanding of your injury (or can get input from those who do) and there is history with using this anesthetic even with people whose brachial plexuses were injured, I'd be very wary.

Kate

Sorry to be so late coming in on this one.
I had a nerve block on my bpi arm when I had surgery done (decompressions) on my wrist two years ago. I'm assuming you are talking about a nerve block for anesthetic purposes only?

In my case, the block was far far better than being put out with a general anesthesia. Sensation returned within an hour after the surgery. I was amazed at how quickly I bounced back from the surgery. Tim and I were birdwatching at a nature preserve later in the same day. I left the hospital before noon on the day of the surgery.

Nancy

Yes I am talking about a nerve block for anesthetic purposes. However it will be used along with general anesthetic during surgery and then it will only be the brachial plexus block for the next three days as my elbow will be in a CPM (continual passive motion) machine. Because they start this machine in the recovery room and keep it going continual for the 3-4 days you're in the hospital. They like to use this type of block to keep my arm numb during the whole hospital stay since the machine could cause a lot of pain and this would definitely minimize the pain. It is a machine that does its own physical therapy. Therefore it is the three days of having the block that bothers me. I am glad to know Nancy that your outcome was good, but I don't know about three days worth of it. Did your anesthesiologist give any indication that the block should not be done on you since you had a brachial plexus injury? Nicole

No he was not concerned and I NEVER get shots in that arm but it had something to do with how they do this block. I also never get blood pressure taken in my bpi arm. To tell you the truth, once they gave me the demoral mixture before surgery, I didn't remember much even though I was awake for this surgery.

I remember asking the surgeon when he was going to start the surgery and he said they were done. The time had passed and I didn't even realize it.

In retrospect, I should have asked more questions during the procedure, but who knows, maybe I did, and now can't remember because of those drugs they give you. You kind of fade in and out.

I wish I could help more.

Nancy