Phrenic nerve palsy secondary to interscalene brachial plexus block
Presentation
Shortness of breath Day 2 post left shoulder rotator cuff surgery. ?Pneumonia ?PE
Patient Data
Left sided interscalene brachial plexus block catheter demonstrated. Elevated left hemidiagphram with subjacent basal atelectasis. No associated hilar, mediastinal or apical mass. The remainder of the lungs and pleural spaces are clear. Anchoring screw within the right humerus.
Follow up xray two weeks later
Follow up xray demonstrates resolution of left hemidiaphragm elevation with removal of scalene block, confirming a transient left phrenic nerve palsy . The patients symptoms had resolved by this point.
Case Discussion
This case nicely demonstrates the normal appearance and potential complication of an interscalene brachial plexus block. This anaesthesic access is frequently used in the setting of shoulder and clavicular surgery. Phrenic nerve palsy is a common complication due shared origin with the upper brachial plexus roots. Palsy will rapidly resolve with cessation of anesthesia.
Other potential complications of scalene brachial plexus block include pneumothorax, total spinal anesthesia, Horners syndrome and recurrent laryngeal nerve palsy.
Unable to process the form. Check for errors and try again.