Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.04.010
Brazilian Journal of Anesthesiology
Case Report

Transient median nerve palsy following ultrasound-guided subscapularis plane block: a case report

Syahrul Mubarak Danar Sumantri, Anna Surgean Veterini

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Abstract

The subscapularis plane block is an effective approach to anesthetize axillary and upper subscapular nerves. There have been no reports regarding brachial plexus paralysis as a potential complication to date. Described here is a case of median nerve palsy following ultrasound-guided subscapularis plane block for awake frozen shoulder manipulation that was performed on a 52-year-old female diagnosed with adhesive capsulitis. The patient could not flex digits two and three, and ipsilateral inner palm numbness occurred shortly after the block commenced, with complete resolution in the next two hours. The local anesthetics spillage towards brachial plexus with possible partial paralysis should always be expected after subscapularis plane block.

Keywords

Case report,  Nerve block,  Adverse effects

References

1 R.V. Sondekoppam, L.M. Lopera-Velasquez, L. Naik, et al. Subscapularis and sub-omohyoid plane blocks: an alternative to peripheral nerve blocks for shoulder analgesia Br J Anaesth, 117 (2016), pp. 831-832

2 J. Tran, A. Agur, P. Peng Deep plane to subscapularis approach for anterior shoulder analgesia: A tribute to Dr Darcy Price Reg Anesth Pain Med, 44 (2019), pp. 759-760

3 R. Drake, D. Vissa, M. Johnson, et al. Subscapularis Plane Block - A Novel Phrenic Nerve Sparing Single Injection Shoulder Block - An Anatomical Study FASEB J, 31 (2017), pp. 903-905

4 J. Tran, P.W.H. Peng, A.M.R. Agur Anatomical study of the innervation of glenohumeral and acromioclavicular joint capsules: Implications for image-guided intervention Reg Anesth Pain Med, 44 (2019), pp. 452-458

5 I. Costabeber, G.M. De Almeida, M. Becker, et al. Brachial plexus cords: A morphological study Rev Bras Anestesiol, 60 (2010), p. 614
 

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