Novel technique for reversing phrenic nerve paresis secondary to interscalene brachial plexus block

  • Ian O Fleming Royal Perth Hospital
  • Krishna Boddu Royal Perth Hospital
Keywords: brachial plexus block, diaphragm, local anaesthetics, phrenic nerve

Abstract

Interscalene brachial plexus block is the reference analgesic technique for shoulder surgery. Phrenic nerve palsy with hemidiaphragmatic paresis is an established complication that results in symptomatic dyspnoea in a small number of subjects, and is poorly tolerated. Established management is supportive and assumes that, once administered, the duration of the block is unalterable. A case is presented of saline washout as a rescue measure for severe dyspnoea due to phrenic nerve palsy following interscalene brachial plexus block. To the authors’ knowledge, this is the first case of this method used to reverse a single-injection brachial plexus block. (Full text available online at www.medpharm.tandfonline.com/ojaa) South Afr J Anaesth Analg 2018; DOI: 10.1080/22201181.2018.1461318

Author Biographies

Ian O Fleming, Royal Perth Hospital
Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth
Krishna Boddu, Royal Perth Hospital
Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth
Published
2018-06-24
Section
Case Studies