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Pleural effusion and chest pain after continuous interscalene brachial plexus block
Vincent Souron1, Youri Reiland, Laurent Delaunay
1Department of Anesthesiology, Clinique Générale, Annecy, France. vsouron@club-internet.fr
Regional Anesthesia and Pain Medicine
|November 25, 2003
Summary
Continuous interscalene brachial plexus block can cause lung complications like atelectasis and pleural effusion. Early chest X-rays are recommended for patients experiencing chest pain post-procedure.
Area of Science:
- Anesthesiology
- Thoracic Surgery
- Radiology
Background:
- Continuous interscalene brachial plexus block is utilized for postoperative analgesia, particularly after shoulder surgery.
- Phrenic nerve block is a known complication of interscalene brachial plexus block, potentially leading to diaphragmatic dysfunction.
Observation:
- A case report details a 45-year-old male who developed left lower lobe atelectasis and pleural effusion after a continuous interscalene brachial plexus block for shoulder arthroscopy.
- The patient presented with left-sided chest pain on the first postoperative day.
Findings:
- Chest X-ray revealed left lower lobe atelectasis and a minor pleural effusion, consistent with ipsilateral phrenic nerve paresis.
- Symptoms resolved within days after catheter removal, indicating a direct correlation with the block.
Implications:
- This case highlights the importance of considering pulmonary complications following interscalene brachial plexus blocks.
- Early postoperative chest X-rays are crucial for diagnosing atelectasis and pleural effusion in patients with chest pain after this type of block.
- Prompt diagnosis and management can prevent long-term sequelae.