We report the case of a 13-year-old male patient, weighing 42 kg, who was proposed for a cadaveric vacuum graft in the right upper limb.
She had a personal history of osteosarcoma and was treated with chemotherapy.
One year before, the tumor was resected with placement of an internal metallic prosthesis.
The patient reported poor pain management despite analgesia with PCA.
One year later, the patient developed a diaphyseal osteonecrosis with extrusion of the prosthesis and was scheduled for a cadaveric bone graft.
She had no other relevant personal history.
Intravenous induction with propofol and remifentanil infusion, intubation with a flexometallic tube without muscle, and later interscalene block guided by ultrasound and neurostimulation at 0.5 ml 0.5% bupivacaine spinal relaxation was performed.
A catheter was placed for continuous brachial plexus block to perform postoperative analgesia.
