• Reg Anesth Pain Med · Mar 2011

    Case Reports

    Ipsilateral brachial plexus block and hemidiaphragmatic paresis as adverse effect of a high thoracic paravertebral block.

    • Steven H Renes, Geert J van Geffen, Miranda M Snoeren, and Gerbrand J Groen.
    • Anesthesiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. s.renes@anes.umcn.nl
    • Reg Anesth Pain Med. 2011 Mar 1;36(2):198-201.

    BackgroundThoracic paravertebral block is regularly used for unilateral chest and abdominal surgery and is associated with a low complication rate.Case ReportsWe describe 2 patients with an ipsilateral brachial plexus block with Horner syndrome after a high continuous thoracic paravertebral block at T2-3. One patient also developed an ipsilateral hemidiaphragmatic paresis, an adverse effect that has not been reported before. Subsequent radiologic examination revealed a limited thoracic cephalad spread of the radiopaque dye and a laterally ascending spread from the thoracic paravertebral space toward and around the brachial plexus. We offer potential explanations for these phenomena.ConclusionsBrachial plexus block can occur by a route parallel to a nerve connecting the second intercostal nerve and T1 nerve, that is, Kuntz nerve. The hemidiaphragmatic paresis was attributed to the ascending spread of local anesthetic toward the area where the phrenic nerve bypasses the subclavian artery and vein.Copyright © 2011 by American Society of Regional Anesthesia and Pain Medicine

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…