Rau R H, Chan Y L, Chuang H I, Cheng C R, Wong K L, Wu K H, Wei T T
Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Acta Anaesthesiol Sin. 1997 Jun;35(2):113-8.
Phrenic nerve paralysis is a common complication in interscalene brachial plexus block. This complication is often ignored by most anesthesiologists because no clinical symptoms occur in patients who have no underlying lung disease. We present a case of an obese male suffering from dyspnea due to phrenic nerve block after interscalene brachial plexus block. The decreased respiratory reserve and direct compressing effect of the abdominal organs on the diaphragm in the supine position are thought to be the risk factors in this obese patient. Also discussed are the incidence, diagnostic methods, clinical presentation and treatments of phrenic nerve paralysis during interscalene brachial plexus block.
膈神经麻痹是肌间沟臂丛神经阻滞常见的并发症。大多数麻醉医生常常忽视这一并发症，因为没有基础肺部疾病的患者不会出现临床症状。我们报告一例肥胖男性患者，在肌间沟臂丛神经阻滞后因膈神经阻滞出现呼吸困难。呼吸储备降低以及仰卧位时腹部脏器对膈肌的直接压迫作用被认为是该肥胖患者发生膈神经麻痹的危险因素。本文还讨论了肌间沟臂丛神经阻滞期间膈神经麻痹的发生率、诊断方法、临床表现及治疗。
