Seizure complicating placement of a nerve stimulator-guided infraclavicular block: could the use of ultrasound decrease the risk?

The case of a patient who suffered a seizure following a nerve stimulator-guided coracoid infraclavicular brachial plexus block, is reported. Following the seizure, an ultrasound machine was used to image the patient's infraclavicular region, which showed an anatomical variation in the position of the axillary vein relative to the axillary artery. The use of ultrasound in regional anesthesia provides additional safety information beyond nerve stimulation, which may help decrease the likelihood of such complications.

Dexmedetomidine for conscious sedation in difficult awake fiberoptic intubation cases.

Currently used methods of sedation for fiberoptic intubation such as benzodiazepines, propofol, or opioids have their limitations. Dexmedetomidine (DEX) is a selective alpha-2 adrenergic agonist that has been used clinically for its sympatholytic, analgesic, and sedative properties. We report on 4 patients with particularly difficult airways who underwent successful awake fiberoptic intubation with DEX.