Persistent Phrenic Nerve Paralysis following Interscalene Brachial Plexus Block

Interscalene block for postoperative analgesia using only ultrasound guidance: the outcome in 200 patients

“…In addition, this approach avoids needle contact with the phrenic nerve as it passes over the AS muscle and into the interscalene groove at the level of the sixth cervical vertebra. Although they are rare, cases of permanent phrenic nerve injury after the classic approach to the ISB have been reported [10,11].…”

Prolonged hemidiaphragmatic paralysis following interscalene brachial plexus block

“…There have been only two such cases described in medical literature, one in 1985 and the other more recently in 2001. 3,4 These describe difficulties with the procedure including multiple attempts and transient phrenic nerve stimulation during the procedure. We present a third case herein, which is unique because it involved a successful interscalene block with no observed diaphragmatic stimulation and an uneventful early postoperative period.…”

Physiology and pathophysiology at high altitude: considerations for the anesthesiologist

“…Regional anesthesia techniques at HA have been reported to be feasible, with onset and offset times for sensory and motor effects similar to those seen with these techniques performed at sea level [82,111,112]. Care needs be taken not to cause phrenic nerve paresis during interscalene brachial plexus, stellate ganglion, and supra-and infraclavicular nerve blocks, because diaphragmatic paralysis or lung injury may lead to respiratory decompensation [112,113].…”

“…Care needs be taken not to cause phrenic nerve paresis during interscalene brachial plexus, stellate ganglion, and supra-and infraclavicular nerve blocks, because diaphragmatic paralysis or lung injury may lead to respiratory decompensation [112,113]. Safar and Tenicela [78] reported, in 1964, a high incidence of post-dural puncture headache following spinal anesthesia at HA.…”