| Paresthesia and Motor Weakness of Left Shoulder after Interscalene Nerve Block: A case report. |
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Jeong Jin Lee, Tae Hyung Han, Baekhyo Shin |
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Department of Anesthesiology, Samsung Medical Center, Seoul, Korea. |
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| Abstract |
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Nerve injury can arise as a complication of peripheral nerve block. Three factors are of special etiologic interest: nerve lesion due to the needle injury or intraneural injection; toxic effects of drugs injected overall when epinephrine is used; ischemic trauma. The symptoms of such nerve lesions are dysesthesia, motor weakness or paralysis.
We report a case of severe neurologic symptoms of left shoulder after interscalene nerve block in a 23-year-old ASA I male patient. Interscalene block utilizing nerve stimulator and elicitation of paresthesia was performed smoothly for incision and drainage of 2nd finger mass. Total 30 cc of 2% lidocaine with epinephrine was used. After the procedure, the patient developed a severe dysesthesia and motor weakness of left shoulder which gradually improved over the next 6 months through the extensive rehabilitation program. The block should be handled with care: rough paresthesia seeking techniques and intraneural injections should be avoided; short bevel needles and plain solutions should be used to avoid complications. |
| Key Words:
Anesthetic technique regional; Complications; peripheral nervous system dysesthesia; motor weakness; interscalene |
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