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  • Title: Delayed onset and long-lasting hemidiaphragmatic paralysis and cranial nerve deficit after interscalene nerve block for rotator cuff repair in beach chair position.
    Author: Chiaghana CO, Awoniyi CA.
    Journal: J Clin Anesth; 2016 Nov; 34():571-6. PubMed ID: 27687453.
    Abstract:
    Hemidiaphragmatic paralysis is the most common adverse effect associated with interscalene block. In most cases, it resolves with the resolution of nerve blockade with only an estimated incidence of 0.048% persisting for longer duration. Occasionally, interscalene block is also associated with recurrent laryngeal nerve block and seldom with cranial nerve paresis. We present a case of delayed onset and prolonged hemidiaphragmatic paralysis that was associated with 3 cranial nerve deficits after interscalene nerve block for shoulder surgery performed under general anesthesia in the beach chair position. Etiology is unclear, but most likely multifactorial.
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