Prolonged nerve blockade in a patient treated with lithium

We report a case of a patient, chronically treated with oral lithium, who presented with an extremely prolonged (42-hour) duration of sensory and motor paralysis following an uneventful infraclavicular block for hand surgery that was performed under ultrasound guidance using bupivacaine and lidocaine. Due to its direct effect on nerve conduction of action potential, we propose that lithium may have had a role in the unusually prolonged duration of a peripheral nerve block.