• Guadalupe Zaragoza-Lemus, Marisol Limón-Muñoz, and Wendy García-Reyes.
• División de Anestesiología, Instituto Nacional de Rehabilitación, Secretaría de Salud, México, D. F., Mexico. zaragoza_lemus@yahoo.com.mx
• Cir Cir. 2012 Jul 1;80(4):352-6.

BackgroundIn shoulder surgery, interscalene brachial plexus block has an incidence of 100% hemidiaphragm palsy due to phrenic nerve block. Controling the hemidiaphragm becomes a security ventilation parameter.Objectiveidentify and evaluate with ultrasound hemidiaphragm paralysis after interscalene block.MethodsThis prospective study included 50 patients scheduled for shoulder surgery with interscalene block using neurostimulation. Diaphragmatic movement was evaluated by ultrasound prior to placement of block and the end of the surgical procedure to make the comparison between the two measurements.ResultsComparing the duration of the respiratory cycle at the start and the end of the surgical procedure, both normal and forced ventilation, there is a statistically significant difference of p < 0.001, as with the depth of the hemidiaphragm was found p < 0.001. 90% of patients had no adverse events, 8% had Horner's syndrome and 2% periauricular hypoesthesia. Hemidiaphragm paralysis was found in all cases, with a volume of 30 mL local anesthetic.ConclusionsUltrasound is a reliable tool that allows real time viewing of the respiratory cycle and measurements of the diaphragm dome it serves to identify diaphragmatic hemiparesis.

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