“I have a paralyzed diaphragm .nerve block counter indicated? ”
Hello. I have a paralyzed right diaphragm. I need LEFT rotator cuff surgery. I am concerned about the brachial plexus nerve block or any other nerve block for that matter because of its affect on my one remaining good phrenic nerve.
Should I get the nerve block? If not… then do I absolutely have to get general anesthesia? I prefer sedation only.
Should I get the nerve block? If not… then do I absolutely have to get general anesthesia? I prefer sedation only.
Female | 66 years old
Complaint duration: 6 months
Medications: None
Conditions: Rotator cuff tear, paralyzed right diaphragm
1 Answer
I dont believe thats contraindication to nerve block. If its already paralyzed on the same side of the shoulder surgery and you dont have respiratory problems with that. However if it is on the other side of the rotator cuff surgery its better to avoid interscalene block since it can cause temporal phrenic nerve block with contralateral diaphragmatic paralysis. In that case you will have bilateral paralysis and might experience respiratory problems. But there are alternatives to interscalene block that would spare phrenic nerve and anesthetise shoulder at the same time. You just need to discuss the issue with your anesthesia provider.
