Ultrasound guided supraclavicular brachial plexus block for excision of multiple calcinosis cutis in CREST syndrome: a safe approach

CREST syndrome is a subset of systemic sclerosis, a multi systemic connective tissue disorder with an autoimmune aetiology. The cardinal features are calcinosis cutis, Raynaud’s phenomenon, oesophageal dysfunction, sclerodactyly and telangectasia. The pathophysiology involves widespread vascular damage and microangiopathic vascular obliteration. It has anaesthetic considerations like difficult airway, reflux oesophagitis, pulmonary aspiration, interstitial lung disease, Raynaud’s phenomenon, cardiomyopathy and difficult venous access. There are very few reports in literature detailing anaesthetic implications. We report successful management of a patient with CREST syndrome posted for excision of calcinosis cutis under ultrasonography (USG) guided supraclavicular brachial plexus block.

DOI: http://dx.doi.org/10.4038/slja.v22i1.6112