Regional - Interscalene block - Complications






Complications of interscalene block

Blockade of neighbouring nerves:

  • Phrenic nerve block (100%)
    • Hemidiaphragm paresis
  • Recurrent laryngeal (10 to 20%)
    • Especially on the right side
    • Hoarse voice
    • May interfere with cough reflex
  • Superior laryngeal (40 to 60%)
  • Cervical ganglion (sympathetic) (10 to 25%, or 70% per ESRA)
    • i.e. Horner's syndrome

Others:

  • Spinal / epidural injection
    • Total spinal is rare
  • Pneumothorax
  • Vertebral artery injection
  • Bezold-Jarisch reflex
    • Hypotension and bradycardia
  • Nerve injury
  • Infection
  • Hematoma
  • LA toxicity