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Aphonia after shoulder surgery: case report.

Carlos Alberto da Silva Soares Moreno¹, Sara Fonseca¹

¹Hospital São João, Porto, Portugal.

Brazilian Journal of Anesthesiology (Elsevier)

|April 26, 2016

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Aphonia, or complete voice loss, is a rare complication following interscalene brachial plexus block (IBPB). This case report details the first instance of aphonia after IBPB, possibly due to a contralateral recurrent laryngeal nerve injury.

Area of Science:

Anesthesiology
Neurology
Otolaryngology

Background:

Interscalene brachial plexus block (IBPB) is a common regional anesthesia technique.
Hoarseness is a known, albeit infrequent, complication of IBPB.
Aphonia, or complete loss of voice, has not been previously reported in association with IBPB.

Observation:

This case report presents the first documented instance of aphonia occurring after an IBPB.
The patient experienced complete loss of voice following the procedure.
The aphonia was suspected to be linked to a pre-existing chronic injury of the recurrent laryngeal nerve on the side opposite the IBPB.

Findings:

Aphonia is an exceptionally rare complication of interscalene brachial plexus block.
The occurrence of aphonia may be attributed to factors independent of the IBPB itself, such as contralateral recurrent laryngeal nerve pathology.

Keywords:

Afonia Aphonia Block Bloqueio Choking Engasgamento I-Gel Interscalene brachial plexus Nervo laríngeo recorrente Plexo braquial interescalênico Recurrent laryngeal nerve

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This highlights the importance of considering non-anesthesia-related causes for vocal disturbances post-IBPB.

Implications:

Anesthesiologists should be aware of aphonia as a potential, though highly unusual, outcome after IBPB.
Evaluation for underlying neurological conditions, particularly recurrent laryngeal nerve dysfunction, is crucial in cases of aphonia post-IBPB.
This case underscores the need for comprehensive patient assessment beyond the immediate effects of regional anesthesia.