Bilateral spread of analgesia following interscalene brachial plexus block

Abstract

Interscalene brachial plexus block has become an accepted technique for surgery involving the upper limb. Several complications have been described which include permanent neurologic damage to the motor outflow of the brachial plexus, inadvertent subarachnoid and epidural blockade, cardiac arrest, hoarseness and Horner's syndrome, carotid bruit, and phrenic nerve palsy. These are infrequent complications and the technique is still considered safe. Two cases of bilateral block without epidural or subarachnoid spread were previously reported. Another case of bilateral block with different features is described.