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Pleural Effusion and Chest Pain After Continuous Interscalene Brachial Plexus Block
  1. Vincent Souron, M.D.,
  2. Youri Reiland, M.D. and
  3. Laurent Delaunay, M.D.
  1. From the Departments of Anesthesiology (V.S., L.D.), Clinique Générale, Annecy, France
  2. Orthopaedic Surgery (Y.R.), Clinique Générale, Annecy, France
  1. Reprint requests: Vincent Souron, MD, Clinique Générale, 4, chemin de La Tour la Reine, 74000 Annecy, France. E-mail: vsouron{at}


Objective We describe a unique case of a patient who experienced atelectasis of the lower lobe of the left lung and pleural effusion manifested by chest pain after continuous interscalene brachial plexus block for postoperative analgesia.

Case Report A 45-year-old man with no respiratory disease was scheduled for left shoulder arthroscopy for rotator cuff repair under interscalene brachial plexus block and sedation. A continuous interscalene brachial plexus block provided postoperative analgesia. On the first postoperative day, the patient reported left-sided chest pain. The chest x-ray showed elevation of the left hemidiaphragm associated with a left lower lobe atelectasis and a minor pleural effusion. After catheter removal, clinical and radiologic signs resolved within few days without sequela.

Conclusion If chest pain presents after interscalene brachial plexus block, early postoperative chest x-ray is recommended to rule out pneumothorax, atelectasis, and/or pleural effusion secondary to ipsilateral phrenic block.

  • Interscalene brachial plexus block
  • Respiratory complication
  • Chest pain
  • Pleural effusion
  • Atelectasis

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