Korean J Anesthesiol.  1996 Dec;31(6):802-806. 10.4097/kjae.1996.31.6.802.

Paresthesia and Motor Weakness of Left Shoulder after Interscalene Nerve Block: A case report

• Lee JJ
• Han TH
• Shin B

• KMID: 2236916
• DOI: http://doi.org/10.4097/kjae.1996.31.6.802

Abstract

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.

Keyword

Anesthetic technique regional; Complications; peripheral nervous system dysesthesia; motor weakness; interscalene

MeSH Terms

Drainage
Epinephrine
Fingers
Humans
Lidocaine
Male
Needles
Nerve Block*
Neurologic Manifestations
Paralysis
Paresthesia*
Peripheral Nerves
Rehabilitation
Shoulder*
Young Adult
Epinephrine
Lidocaine