Can bilateral bronchospasm be a sign of unilateral phrenic nerve palsy after supraclavicular brachial plexus block?

• Main Authors: Souvik Chaudhuri, M D Gopalkrishna, Cherish Paul, Ratul Kundu
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2012-01-01
• Series: Journal of Anaesthesiology Clinical Pharmacology
• Subjects: Bronchospasm; phrenic nerve blockade; supraclavicular block; ultrasound guided
• Online Access: http://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=2;spage=249;epage=251;aulast=Chaudhuri

Ultrasound-guided peripheral nerve blocks facilitate ambulatory anesthesia for upper limb surgeries. Unilateral phrenic nerve blockade is a common complication after interscalene brachial plexus block, rather than the supraclavicular block. We report a case of severe respiratory distress and bilateral bronchospasm following ultrasound-guided supraclavicular brachial plexus block. Patient did not have clinical features of pneumothorax or drug allergy and was managed with oxygen therapy and salbutamol nebulization. Chest X-ray revealed elevated right hemidiaphragm confirming unilateral phrenic nerve paresis.