Low-concentration, continuous brachial plexus block in the management of Purple Glove Syndrome: A case report

Georgene Singh, Verghese T. Cherian, Binu P. Thomas

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction. Purple Glove Syndrome is a devastating complication of intravenous phenytoin administration. Adequate analgesia and preservation of limb movement for physiotherapy are the two essential components of management. Case presentation. A 26-year-old Tamil woman from India developed Purple Glove Syndrome after intravenous administration of phenytoin. She was managed conservatively by limb elevation, physiotherapy and oral antibiotics. A 20G intravenous cannula was inserted into the sheath of her brachial plexus and a continuous infusion of bupivacaine at a low concentration (0.1%) with fentanyl (2 g/ml) at a rate of 1 to 2 ml/hr was given. She had adequate analgesia with preserved motor function which helped in physiotherapy and functional recovery of the hand in a month. Conclusion. A continuous blockade of the brachial plexus with a low concentration of bupivacaine and fentanyl helps to alleviate the vasospasm and the pain while preserving the motor function for the patient to perform active movements of the finger and hand.

Original languageEnglish (US)
Article number48
JournalJournal of Medical Case Reports
Volume4
DOIs
StatePublished - Mar 8 2010

Fingerprint

Bupivacaine
Phenytoin
Fentanyl
Intravenous Administration
Analgesia
Extremities
Hand
Brachial Plexus
Fingers
India
Anti-Bacterial Agents
Pain
Brachial Plexus Block
Cannula

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{2e29c91609344417801ad47f399966c8,
title = "Low-concentration, continuous brachial plexus block in the management of Purple Glove Syndrome: A case report",
abstract = "Introduction. Purple Glove Syndrome is a devastating complication of intravenous phenytoin administration. Adequate analgesia and preservation of limb movement for physiotherapy are the two essential components of management. Case presentation. A 26-year-old Tamil woman from India developed Purple Glove Syndrome after intravenous administration of phenytoin. She was managed conservatively by limb elevation, physiotherapy and oral antibiotics. A 20G intravenous cannula was inserted into the sheath of her brachial plexus and a continuous infusion of bupivacaine at a low concentration (0.1{\%}) with fentanyl (2 g/ml) at a rate of 1 to 2 ml/hr was given. She had adequate analgesia with preserved motor function which helped in physiotherapy and functional recovery of the hand in a month. Conclusion. A continuous blockade of the brachial plexus with a low concentration of bupivacaine and fentanyl helps to alleviate the vasospasm and the pain while preserving the motor function for the patient to perform active movements of the finger and hand.",
author = "Georgene Singh and Cherian, {Verghese T.} and Thomas, {Binu P.}",
year = "2010",
month = "3",
day = "8",
doi = "10.1186/1752-1947-4-48",
language = "English (US)",
volume = "4",
journal = "Journal of Medical Case Reports",
issn = "1752-1947",
publisher = "BioMed Central",

}

Low-concentration, continuous brachial plexus block in the management of Purple Glove Syndrome : A case report. / Singh, Georgene; Cherian, Verghese T.; Thomas, Binu P.

In: Journal of Medical Case Reports, Vol. 4, 48, 08.03.2010.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Low-concentration, continuous brachial plexus block in the management of Purple Glove Syndrome

T2 - A case report

AU - Singh, Georgene

AU - Cherian, Verghese T.

AU - Thomas, Binu P.

PY - 2010/3/8

Y1 - 2010/3/8

N2 - Introduction. Purple Glove Syndrome is a devastating complication of intravenous phenytoin administration. Adequate analgesia and preservation of limb movement for physiotherapy are the two essential components of management. Case presentation. A 26-year-old Tamil woman from India developed Purple Glove Syndrome after intravenous administration of phenytoin. She was managed conservatively by limb elevation, physiotherapy and oral antibiotics. A 20G intravenous cannula was inserted into the sheath of her brachial plexus and a continuous infusion of bupivacaine at a low concentration (0.1%) with fentanyl (2 g/ml) at a rate of 1 to 2 ml/hr was given. She had adequate analgesia with preserved motor function which helped in physiotherapy and functional recovery of the hand in a month. Conclusion. A continuous blockade of the brachial plexus with a low concentration of bupivacaine and fentanyl helps to alleviate the vasospasm and the pain while preserving the motor function for the patient to perform active movements of the finger and hand.

AB - Introduction. Purple Glove Syndrome is a devastating complication of intravenous phenytoin administration. Adequate analgesia and preservation of limb movement for physiotherapy are the two essential components of management. Case presentation. A 26-year-old Tamil woman from India developed Purple Glove Syndrome after intravenous administration of phenytoin. She was managed conservatively by limb elevation, physiotherapy and oral antibiotics. A 20G intravenous cannula was inserted into the sheath of her brachial plexus and a continuous infusion of bupivacaine at a low concentration (0.1%) with fentanyl (2 g/ml) at a rate of 1 to 2 ml/hr was given. She had adequate analgesia with preserved motor function which helped in physiotherapy and functional recovery of the hand in a month. Conclusion. A continuous blockade of the brachial plexus with a low concentration of bupivacaine and fentanyl helps to alleviate the vasospasm and the pain while preserving the motor function for the patient to perform active movements of the finger and hand.

UR - http://www.scopus.com/inward/record.url?scp=77649129821&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77649129821&partnerID=8YFLogxK

U2 - 10.1186/1752-1947-4-48

DO - 10.1186/1752-1947-4-48

M3 - Article

C2 - 20205899

AN - SCOPUS:77649129821

VL - 4

JO - Journal of Medical Case Reports

JF - Journal of Medical Case Reports

SN - 1752-1947

M1 - 48

ER -