PDF(Pubmed)
Abstract：
Interscalene nerve blocks are common procedures performed before upper extremity surgeries in order to provide post-op pain relief and improve recovery time. Here we present two cases of patients who underwent a unilateral supraclavicular and bilateral interscalene nerve block, respectively. The first patient had no risk factors but the second presented with a body mass index of 45.5 and a history of symptoms consistent with obstructive sleep apnea but never diagnosed. Both patients experienced some form of respiratory distress diagnosed via changes in chest x-ray and clinical presentation. The mechanism of injury that occurs in these procedures is typically from inadvertent damage to the phrenic nerve. Mild adverse effects in interscalene nerve block are relatively common. However, there is minimal data in regards to performing bilateral interscalene nerve blocks. The purpose of this study is to highlight that severe complication in both high and low-risk patients can occur but may be reduced with a safer approach and more effective communication among multidisciplinary team members.
摘要：
肌间沟神经阻滞是上肢手术前进行的常见程序，目的是缓解术后疼痛并改善恢复时间。在这里，我们介绍了两例接受单侧锁骨上和双侧肌间沟神经阻滞的患者，分别。第一例患者没有危险因素，但第二例患者的体重指数为45.5，症状史与阻塞性睡眠呼吸暂停一致，但从未诊断。两名患者均通过胸部X射线和临床表现的变化诊断出某种形式的呼吸窘迫。在这些手术中发生的损伤机制通常是由于对膈神经的无意损伤。肌间沟神经阻滞的轻度不良反应比较常见。然而,关于进行双侧肌间沟神经阻滞的数据很少.这项研究的目的是强调高风险和低风险患者都可能发生严重并发症，但可以通过更安全的方法和多学科团队成员之间更有效的沟通来减少并发症。
