AXILLARY PLEXUS BLOCKADE IN MICROVASCULAR SURGERY, A STEAL PHENOMENON

A case report is presented of an axillary plexus blockade following a second toe-to-hand transfer. After completion of the microvascular ana stomoses and restoration of blood flow to the transplanted toe, the ax illary plexus blockade was started, Together with the vasodilation of the hand and forearm there was a marked drop in blood flow in the tran splanted toe. Possible explanations for this phenomenon are considered . We suggest starting axillary plexus blockade before completion of mi crovascular anastomoses and maintaining a continuous postoperative blo ckade. (C) 1995 Wiley-Liss, Inc.