I appreciate the comments from Dr. Sciard et al.  regarding alternative anesthetic approaches in this case, which deserve consideration. However, the notable aspect of this case and the motivation for reporting it was the fact that this was the first described case of induced hypotension in association with a brachial plexus block. In addition, we were impressed by how easy it was to induce and stabilize the hypotensive state during surgery without resorting to controlled ventilation and general anesthesia. This is probably due to a combination of a solid block, careful patient positioning, and intravenous propofol.