Hemidiaphragmatic paralysis is initially recognised as postoperative respiratory distress. The subsequent sequential management of the patient following arthroscopic shoulder surgery under interscalene block is described. Ultrasound-guided technique is considered to be the safest for interscalene block. Reducing the volume of anaesthetic used reduces its spread to the phrenic nerve and thus reduces the incidence of hemidiaphragmatic paralysis. Furthermore, a reduction in anaesthetic volume has equivalent analgesic efficacy.
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Respiratory impact of local anaesthetic volume after an interscalene brachial plexus block with an extrafascial injection: a randomised controlled double-blinded trial.
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Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland. Electronic address:
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Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.600 Yishan Road, Xuhui District, Shanghai, 200233, People's Republic of China.
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