Nerve blockade as a therapeutic option in severe neonatal arterial ischaemia

We report the use of regional nerve blockade in the management of arterial limb ischaemia. A female infant weighing 815 g was born spontaneously at 26 weeks' gestation. At birth the baby required resuscitation with endotracheal intubation. Soon after birth she underwent arterial blood gas analysis by direct puncture of the right radial artery. At 5 h of life her right hand was cool, with oedema of the third, fourth and fifth fingers and cyanotic discoloration of the fourth and fifth distal phalanges. The radial pulse was absent. As a cerebral ultrasound examination showed no intraventricular haemorrhage, systemic fibrinolytic treatment was started. However, this had to be discontinued after 24 h because …