Total spinal anesthesia after an interscalene block.

A case study is presented involving a 22-year-old male who developed total spinal anesthesia after interscalene blockade for an arthroscopic procedure of the shoulder. An understanding of the anatomical structures of the brachial plexus, autonomic nervous system function, and side effects of local anesthetics is presented to assist the perianesthetic nurse in assessing and anticipating patient needs and in clinical decision making.