Diaphragm-Sparing Nerve Blocks for Shoulder Surgery

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(Abstracted from Reg Anesth Pain Med, 42(1):32–38, 2017)The main aim of this article is to arrive at feasible diaphragm-sparing alternatives to interscalene brachial plexus blocks (ISBs) that can provide satisfactory surgical local anesthesia and postoperative pain relief with a low incidence of hemidiaphragmatic paralysis. The most common adverse effect of ISB for standard post–shoulder surgery analgesia is the occurrence of ipsilateral phrenic nerve block which causes a hemidiaphragmatic paralysis in 100% of patients and a 27% decrease in the patients forced vital capacity and forced expiratory volume at 1 second.

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