Safe and Effective Analgesia Using Ultrasound-Guided Brachial Plexus Block for Upper Limb Compartment Syndrome: A Case Report

Upper limb compartment syndrome (ULCS) is a life-threatening and uncommon medical disorder that develops when the pressure within one or more muscle compartments of the upper limb increases. Consequently, it limits blood flow and leads to ischemia of the muscles and nerves. The objective of this case report was to analyze the safe and effective utilization of ultrasound-guided posterior interscalene brachial plexus block (USG-ISB) to document sufficient analgesia, maintenance of respiratory function, and hemodynamic stability in the treatment of ULCS. In this case report, the patient presented with severe right upper limb pain and signs of ischemia due to trauma. The primary treatment, surgical fasciotomy, was performed in an emergency setting to alleviate compartment pressure. An USG-ISB was applied as an adjunct to anesthetic management to provide safe and adequate analgesia and to stabilize the patient hemodynamically. It also reduced the need for systemic opioid use. This regional anesthesia technique was not associated with any perioperative complications, and no further morbidity was observed during the 23-day hospital stay. Following adequate regional anesthesia administration, the patient reported only mild disability (QuickDASH score of 5) at the 3-month follow-up. This case emphasizes the importance of USG-ISB as an effective and safe technique for achieving adequate analgesia and hemodynamic stabilization without delaying the diagnosis of compartment syndrome, owing to appropriate monitoring (ultrasound, serial neurovascular checks) during hospitalization and the involvement of a multidisciplinary team.