Brachial plexus infusion of ropivacaine with patient-controlled supplementation.

PURPOSE: To report the use of continuous brachial plexus analgesia to facilitate physiotherapy

CLINICAL FEATURES: A 34-yr-old man had contractures of the fingers of his dominant hand following a crush injury in 1996. After several operations, he continued to experience severe pain and disability. In order to facilitate painfree active and passive physiotherapy, we performed an axillary brachial plexus block. After insertion of a brachial plexus catheter via the axilla, analgesia was continued for a period of one week using a 3 mlxhr(-1) background infusion of ropivacaine 0.2% with the facility for additional patient-controlled 1 ml boluses. Both active and passive physiotherapy was carried out daily for the entire week.

CONCLUSION

This technique was successful with no major complications and resulted in a marked reduction in pain, with improved range of finger movement and general upper limb function.