Medical MCQ-A Patient in the ICU was on invasive monitoring with intra aerial cannulation through the right hand. For the last 3 days later he developed swelling and discoloration of the right hand. What should be the next line of management in this patient?

A Patient in the ICU was on invasive monitoring with intra aerial cannulation through the right hand. For the last 3 days later he developed swelling and discoloration of the right hand. What should be the next line of management in this patient?

Brachial block

Stellate ganglion block

Application of lignocaine jelly over the site

Radial nerve block on the same side

Question Category:

Anaesthesia

Correct Answer:

Stellate ganglion block

Description:

This patient most likely would have developed aerial spasm and limb ischemia a potential complication of intra aerial cannulation. Sympathetic neuron blockage either of stellate ganglion or brachial plexus produces prolonged vasodilation to improve circulation and tissue oxygenation. Stellate ganglion block is quicker to perform but will not provide analgesia afforded by a brachial plexus block. So stellate ganglion block should be done immediately in this patient. Other potential complications of intra aerial monitoring are: Hematoma Neurologic injury Aerial embolization Limb ischemia Infection Inadveent intra aerial injection of drugs Ref: Sabiston Textbook of Surgery: Expe Consult Premium Edition: Enhanced By Couney M. Townsend Jr., R. Daniel Beauchamp.

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