Ultrasound-guided Interscalene Block as a Safer Alternative to General Anesthesia in a Patient with Ankylosing Spondylitis Undergoing Proximal Humerus Fracture Fixation

Abstract

Ankylosing spondylitis (AS) presents significant anesthetic challenges due to restricted cervical spine mobility and an anticipated difficult airway. General anesthesia may increase perioperative risk, particularly in emergency settings. We report the anesthetic considerations of a 58-year-old male of short stature with suspected AS and severely restricted neck movements, posted for emergency fixation of a proximal humerus fracture. Considering the anticipated difficult airway, ultrasound-guided interscalene brachial plexus block was administered as the sole anesthetic technique. Ultrasound-guided interscalene block plays a crucial role as an alternative to general anesthesia in AS patients undergoing upper limb surgery, particularly when airway management is expected to be challenging.