Respiratory distress after a Nadbath block

Dysphagia and respiratory distress developed in three patients after administration of a Nadbath block. This complication may have resulted from inadvertent paralysis of the vagus, ipsilateral glossopharyngeal, and spinal accessory nerves causing pooling of oropharyngeal secretions and laryngospasm. Respiratory distress after a Nadbath block may be managed by properly positioning the patient. Short hypodermic needles (less than 12 mm), small volumes of anesthetic solution (less than 3 ml), and omission of hyaluronidase may reduce the incidence of this complication.