Vertical infraclavicular blockade

A 50 year old female patient received anaesthesia of the arm by the vertica l infraclavicular blockade of the plexus brachialis (VIP). Postoperatively an ipsilateral pneumothorax occured complicated by pleural effusion and a c ontralateral bronchopneumonia, which resolved completely after treatment. T he blockade of the plexus was performed correctly, failures in determining the correct point of needle insertion could be excluded. Therefore a pneumo thorax has to be regarded as a specific complication of the VIP, which migh t occur despite correct technique, and requires that the patient be informe d of this eventuality. Nevertheless, the VIP is an important method due to its high success rate concerning blockade of the musculocutaneous nerve and tolerance of tourniquet. The risk of a pneumothorax is about 0.2 to 0.7%.