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


METHODS
A 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.


CONCLUSIONS
If 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.
Souron
Vincent
V
Department of Anesthesiology, Clinique Générale, Annecy, France. vsouron@club-internet.fr
Reiland
Youri
Y
Delaunay
Laurent
L
D001340:Autonomic Nerve Block / Q000009:adverse effects*; D001917:Brachial Plexus / Q000187:drug effects / Q000473:pathology*; D002637:Chest Pain / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000139:chemically induced / Q000175:diagnosis*; D012785:Shoulder Joint / Q000187:drug effects / Q000601:surgery