Question

While giving the second injection around the brachial plexus sheath the patient has a painful paresthesias shooting down the arm. Which of the following represent the appropriate responses by the anesthetist?

Answer 1

The shooting pain down the arm during an injection around the brachial plexus sheath is an example of referred pain. It occurs when strong sensations from one area are felt in another area. In this case, the sensory fibers from the heart are mistakenly interpreted by the brain as sensations from the arm.

Step-by-step explanation:

The painful paresthesias shooting down the arm while giving the second injection around the brachial plexus sheath is likely an example of referred pain. Referred pain occurs when strong visceral sensations rise to the level of conscious perception and are felt in unexpected places. In this case, the visceral sensory fibers from the mediastinal region, where the heart is located, enter the same level of the spinal cord as the somatosensory fibers of the brachial plexus, leading to the brain misinterpreting the sensations from the heart as being from the arm.