title: Delayed vocal fold paralysis after continuous interscalene level brachial plexus block with catheter placement: a case report.
abstract: We report an incident of delayed onset of true vocal fold paralysis with continuous interscalene brachial plexus block. A 51 year old woman underwent left shoulder manipulation and lysis of adhesions with fluoroscopy and general anesthesia. An interscalene brachial plexus block was performed and a catheter with a continuous infusion pump was placed for postoperative pain control. Following hospital discharge, approximately 8 hours after the initial catheter bolus the patient developed hoarseness, dysphagia, and dyspnea, secondary to left vocal fold palsy. The patient was admitted for observation and the catheter was discontinued with no intubation required. By the next morning, the patient's dysphagia and dyspnea had resolved and her hoarseness improved.
authors.affiliation: Department of Anesthesiology, Wayne State University/Detroit Medical Center, Detroit, MI 48201, USA.
authors.forename: Lakshman
authors.initials: L
authors.lastname: Gollapalli
authors.affiliation: Department of Anesthesiology, Wayne State University/Detroit Medical Center, Detroit, MI 48201, USA.
authors.forename: George
authors.initials: G
authors.lastname: McKelvey
authors.affiliation: Department of Anesthesiology, Wayne State University/Detroit Medical Center, Detroit, MI 48201, USA. Electronic address: howang@med.wayne.edu.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D065527:Brachial Plexus Block / Q000009:adverse effects* / Q000379:methods; D002404:Catheterization / Q000379:methods*; D003680:Deglutition Disorders / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D014826:Vocal Cord Paralysis / Q000209:etiology*
keywords: Anesthesia regional; Continuous interscalene brachial plexus block; Dysphagia; Dyspnea; Laryngeal nerve palsy; Upper extremity surgery; Vocal fold paralysis