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Bilateral infraclavicular brachial plexus nerve blocks in an ambulatory surgery center

The approach for upper extremity surgery brachial plexus blocks depends on the specific nature of the surgery. Interscalene and supraclavicular brachial plexus blocks can cause phrenic nerve palsy. Our aim was to explore the safety of bilateral parasagittal infraclavicular brachial plexus blocks (BPBBs) in an outpatient surgery center. Identical BPBBs were performed in two patients with 20 mL of 0.25% bupivacaine. Neither patient developed respiratory or cardiovascular distress. Brachial plexus blocks on multiple locations are infrequently employed for fear of phrenic nerve paresis. However, given both patients’ success, bilateral parasagittal infraclavicular brachial plexus blocks may provide a safe approach. Keywords: Nerve block, brachial plexus blocks, phrenic nerve, anesthesia, pain