Ultrasound-Guided Supraclavicular Block in a Patient with Toxic Goiter and Exposed Wrist Fracture

We report the case of an elderly woman with cervical deformity due to a large diffuse goiter and predictive data for a difficult airway, alteration of all thyroid hormone levels and an exposed wrist fracture. After a pre-block ultrasound scan, the supraclavicular approach to the brachial plexus was selected because the gland growth was in the anterior to posterior axis, without displacement of the anatomical structures in the neck. We then proceeded to insert the needle using an in-plane technique with a linear probe in an oblique coronal plane to inject the local anesthetic and observe its adequate diffusion. Excellent anesthesia was achieved for the surgical procedure avoiding other complications.