RETURNYonago Acta medica 1991;34:287-292
Atelectasis after Interscalene Brachial Plexus Block: A Case Report
Genro Ochi, Fumito Kadoya, Seitaro Oka, Etsuo Tabo, Takumi Nagaro and Tatsuru Arai
Department of Anesthesiology, Ehime University School of Medicine, Shigenobu-cho 791-02, Japan
We report a case of intraoperative atelectasis and respiratory distress after an interscalene brachial plexus block (BPB). The patient was a 56-year-old man who underwent a replantation of the left thumb after that finger was accidentally severed. Respiratory distress was noted 15 min after BPB. He was intubated and artificial ventilation was provided. A large amount of secretion was suctioned from the endotracheal tube and a chest x-ray film showed atelectasis of the left lower lobe. Mechanical ventilation was continued until 13 h after the operation when the x-ray film showed a reexpansion of the left lung. Increased bronchial secretion and a hemilateral phrenic nerve block following interscalene BPB were considered to be the most likely causes of atelectasis. In conclusion, interscalene BPB is not recommended for patients with respiratory risk factors.
Key words: anesthesia; atelectasis; brachial plexus block; complication; interscalene technique