Functional deficits after intraneural injection during interscalene block.
OBJECTIVE
We present an occurrence of a severe but transient neurologic complication after intraneural injection during an ultrasound-guided interscalene block.


METHODS
A 36-year-old man underwent ultrasound-guided interscalene nerve blockade before shoulder incision and drainage. On postoperative day 1, he exhibited new-onset arm weakness with dysesthesias. Intraneural injection was recognized based on a retrospective review of the recorded ultrasound imaging. The symptoms persisted for more than 2 weeks and completely resolved by 6 weeks.


CONCLUSIONS
Our report suggests that intraneural injection during ultrasound-guided interscalene block carries a risk of neurologic complications.
Cohen
Joshua M
JM
Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94110, USA.
Gray
Andrew T
AT
D000328:Adult; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001917:Brachial Plexus / Q000000981:diagnostic imaging / Q000187:drug effects / Q000293:injuries* / Q000503:physiopathology; D002045:Bupivacaine / Q000008:administration & dosage; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D007267:Injections; D008297:Male; D018908:Muscle Weakness / Q000209:etiology; D009407:Nerve Block / Q000009:adverse effects*; D010292:Paresthesia / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology; D012782:Shoulder / Q000294:innervation* / Q000601:surgery; D013748:Tetracaine / Q000008:administration & dosage; D018084:Ultrasonography, Interventional
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D013748:Tetracaine; D002045:Bupivacaine