Diaphragmatic paralysis following scalenotomy for thoracic outlet syndrome

Potential phrenic nerve injury that results in diaphragmatic dysfunction and respiratory insufficiency has important implications for the anesthesiologist who must insure adequate ventilation and gas exchange. A variety of traumatic injuries as well as some surgical manipulations have been identified with an increased frequency of diaphragmatic paralysis. We have observed the occurrence of this sequelae after scalenotomy for thoracic outlet obstruction, a previously unreported association.