| Summary: | <span style="font-family: Verdana; font-size: small;"><strong>Introduction:</strong> Regional anesthesia has experienced major changes in recent years, particularly due to the use of electrostimulation and ecogram. The unilateral paralysis of the diaphragm is a secondary complication after blocking the supraclavicular brachial plexus, with an incidence of 50 to 67 %. The introduction of echolocation is not exempt from this. Every scholar should provide all the details related to it, so that they can serve as a guide to the coming generations.<br /> <strong>Objective:</strong> To increase knowledge on the management of patients with peripheral nerve blocks under the use of ultrasound and the importance of following them.<br /> <strong>Clinical case:</strong> 60-year-old patient with 82 kg of weight, which was planned elective surgery to remove tumor from the forearm. The patient had antecedents of hypertensive ischemic heart disease treated with the placement of two stents. It was decided to lock the supraclavicular brachial plexus, obtaining a correct locking, but there was a unilateral paralysis of the diaphragm with implications for the patient's welfare.<br /> <strong>Conclusions: </strong>despite using ultrasound for peripheral nerve blocks, you must follow a strict monitoring of each patient throughout the surgical act.</span>
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