Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.009
Brazilian Journal of Anesthesiology
Case Report

Permanent hemidiaphragmatic paresis after interscalene brachial plexus block: a case report

Paresia hemidiafragmática pemanente após bloqueio interescaleno do plexo braquial: relato de caso

Nina Cugnin, Benjamin Le Gaillard, Edmundo Pereira de Souza Neto

Downloads: 1
Views: 52

Abstract

Interscalene brachial plexus block has been widely used in shoulder surgery. We report one case of long-term phrenic palsy following ultrasound-guided interscalene brachial plexus block and we will discuss the possible etiology and mechanism of this disability. For painful shoulder surgery, ultrasound-guided interscalene brachial plexus block remains topical. Alternative blocks, such as suprascapular and axillary blocks, may be reserved for patients with pre-existing respiratory pathology.

Keywords

Regional anesthetic techniques;  Interscalene block;  Neurologic symptoms

References

1 CL Beecroft, DM. Coventry Anaesthesia for shoulder surgery CEACCP., 8 (2008), pp. 193-198

2 K. El-Boghdadly, K.J. Chin, V.W.S. Chan Phrenic nerve palsy and regional anesthesia for shoulder surgery: anatomical, physiologic, and clinical considerations Anesthesiology., 27 (2017), pp. 173-191

3 MP Buise, RA Bouwman, A van der Gaag, et al. Phrenic nerve palsy following interscalene brachial plexus block; a long-lasting serious complication Acta Anaesthesiol Belg., 66 (2015), pp. 91-94

4 S. Riazi, N. Carmichael, I. Awad, et al. Effect of local anaesthetic volume (20 vs. 5 mL) on the efficacy and respiratory consequences of ultrasound-guided interscalene brachial plexus block Br J Anaesth., 101 (2008), pp. 549-556

5 P. Marty, F. Ferre, B. Basset, et al. Diaphragmatic paralysis in obese patients in arthroscopic shoulder surgery: consequences and causes J Anesth., 32 (2018), pp. 333-340

6 A. Borgeat, G. Ekatodramis, F. Kalberer, C. Benz Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study Anesthesiology., 95 (2001), pp. 875-880

7 A. Borgeat, A. Dullenkopf, G. Ekatodramis, L. Nagy Evaluation of the lateral modified approach for continuous interscalene block after shoulder surgery Anesthesiology., 99 (2003), pp. 436-442

8 K.D. Candido, R. Sukhani, R. Doty Jr, et al. Neurologic sequelae after interscalene brachial plexus block for shoulder/upper arm surgery: The association of patient, anesthetic, and surgical factors to the incidence and clinical course Anesth Analg., 100 (2005), pp. 1489-1495

9 W.D. Xu, Y.D. Gu, J.B. Lu, et al. Pulmonary function after complete unilateral phrenic nerve transection J Neurosurg., 103 (2005), pp. 464-467

10 G. Gayan-Ramirez, N. Gosselin, T. Troosters, F. Bruyninckx, R. Gosselink, M. Decramer Functional recovery of diaphragm paralysis: a long-term follow-up study Respir Med., 102 (2008), pp. 690-698

11 J. Ricoy, N. Rodríguez-Núñez, J.M. Álvarez-Dobaño, et al. Diaphragmatic dysfunction Pulmonology., 25 (2019), pp. 223-235

12 C. Gonano, S.C. Kettner, M. Ernstbrunner, et al. Comparison of economic aspects of Interscalene Brachial plexus blockade and general anaesthesia for arthroscopic shoulder surgery Br J Anaesth., 103 (2009), pp. 428-433
 

602693b40e8825647b68ae7a rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections