Review of Persistent Phrenic Nerve Palsy

Regional anesthesia techniques for orthopedic surgeries have become more frequently utilized for postoperative analgesia. A commonly used technique for shoulder surgery is the interscalene brachial plexus nerve block which involves anesthetizing nerves of the shoulder. Unfortunately, patients can experience a transient phrenic nerve block resulting in dyspnea. Rarely this develops into a persistent phrenic nerve block that can out last the duration of the local anesthetics deposited around the brachial plexus. Patients with a persistent phrenic nerve block can present to neurologists and other specialists with symptoms that appear to have a cardiac or pulmonary etiology requiring prompt diagnosis and management.