• Reg Anesth Pain Med · Nov 2003

    Case Reports

    Pleural effusion and chest pain after continuous interscalene brachial plexus block.

    • Vincent Souron, Youri Reiland, and Laurent Delaunay.
    • Department of Anesthesiology, Clinique Générale, Annecy, France. vsouron@club-internet.fr
    • Reg Anesth Pain Med. 2003 Nov 1; 28 (6): 535-8.

    ObjectiveWe describe a unique case of a patient who experienced atelectasis of the lower lobe of the left lung and pleural effusion manifested by chest pain after continuous interscalene brachial plexus block for postoperative analgesia.Case ReportA 45-year-old man with no respiratory disease was scheduled for left shoulder arthroscopy for rotator cuff repair under interscalene brachial plexus block and sedation. A continuous interscalene brachial plexus block provided postoperative analgesia. On the first postoperative day, the patient reported left-sided chest pain. The chest x-ray showed elevation of the left hemidiaphragm associated with a left lower lobe atelectasis and a minor pleural effusion. After catheter removal, clinical and radiologic signs resolved within few days without sequela.ConclusionIf chest pain presents after interscalene brachial plexus block, early postoperative chest x-ray is recommended to rule out pneumothorax, atelectasis, and/or pleural effusion secondary to ipsilateral phrenic block.

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