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The Ultrasound Journal
Published in: The Ultrasound Journal 2/2011

Open Access 01-08-2011 | Case Report

Hypoxic respiratory failure due to phrenic nerve palsy from an interscalene brachial plexus block and previously asymptomatic pulmonary embolism

Authors: Danielle M. Minett, Jason E. Nace, Jason T. Nomura

Published in: The Ultrasound Journal | Issue 2/2011

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Abstract

Interscalene brachial plexus block is a common regional anesthesia method for upper extremity surgery. A rare complication of this procedure is dyspnea secondary to phrenic nerve palsy and hemidiaphragm paralysis. In our case, this rare complication diagnosed using ultrasound led to the diagnosis of a previously asymptomatic pulmonary embolism. The use of ultrasonography was key in the diagnosis of the iatrogenic nerve palsy and was part of a multiple-modality diagnostic workup for her hypoxemia.
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Urmey WF, McDonald M (1992) Hemidiaphragmatic paresis during interscalene brachial plexus block: effects on pulmonary function and chest wall mechanics. Anesth Analg 74(3):352–357PubMedCrossRef
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Rau RH, Chan YL, Chuang HI et al (1997) Dyspnea resulting from phrenic nerve paralysis after an interscalene brachial plexus block in an obese male- a case report. Acta Anaesthesiol Sin 35(2):113–118PubMed
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Erickson JM, Louis DS, Naughton NN (2009) Symptomatic phrenic nerve palsy after supraclavicular block in an obese man. Orthopedics 32(5):368PubMedCrossRef
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Renes SH, Rettig HC et al (2009) Ultrasound-guided low dose interscalene brachial plexus block reduces the incidence of hemidiaphragmatic paresis. Reg Anesth Pain Med 34(5):498–502PubMedCrossRef
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Raymond CS, Borel JC et al (2008) Persistant phrenic nerve palsy following interscalene block, leading to chronic respiratory insufficiency and requiring long term non-invasive ventilation. Respir Med CME 1:253–255CrossRef
Metadata
Title
Hypoxic respiratory failure due to phrenic nerve palsy from an interscalene brachial plexus block and previously asymptomatic pulmonary embolism
Authors
Danielle M. Minett
Jason E. Nace
Jason T. Nomura
Publication date
01-08-2011
Publisher
Springer Milan
Published in
The Ultrasound Journal / Issue 2/2011
Electronic ISSN: 2524-8987
DOI
https://doi.org/10.1007/s13089-011-0076-1

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