Cervical Epidural for an Urgent Bilateral Shoulder Surgery: A Case Report

Effective postoperative analgesia for bilateral shoulder arthroplasties may represent a challenge to anesthesiologists. While the interscalene nerve block is commonly used to provide intraoperative and postoperative analgesia, bilateral interscalene block is not feasible due to phrenic nerve paralysis risk. Alternative phrenic nerve-sparing techniques may be considered; however, these often require multiple injections and may not offer comprehensive pain relief. We present a 62-year-old post-lung transplant man with bilateral shoulder dislocation and humerus fracture requiring urgent bilateral shoulder arthroplasties. A cervical epidural was used intraoperatively with general anesthesia and postoperatively for analgesia. The patient recovered uneventfully and was discharged postoperative day 6 (POD 6).