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Regional anesthesia with noninvasive ventilation for shoulder surgery in a patient with severe chronic obstructive pulmonary disease: a case report

Abstract : Interscalene block (ISB) impairs ipsilateral lung function and generally is not used for patients with respiratory insufficiency. We present a 49-year-old man with chronic obstructive pulmonary disease scheduled for shoulder surgery. He was given a regional technique with an ISB (short-acting local anesthetic to minimize duration of diaphragmatic dysfunction) and suprascapular and axillary nerves blocks (long-acting local anesthetic). He was supported with noninvasive ventilation during the time of hemidiaphragmatic paralysis as documented by serial ultrasound examination. A discussion about ISB and its alternatives (general anesthesia versus brachial plexus block versus selective peripheral nerve blocks) always should occur for patients at risk for pulmonary complications.
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https://hal.archives-ouvertes.fr/hal-02135092
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Submitted on : Tuesday, May 21, 2019 - 9:11:34 AM
Last modification on : Wednesday, January 22, 2020 - 11:20:03 AM

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Fabrice Ferré, Nina Cugnin, Charlotte Martin, Philippe Marty, Nicolas Bonnevialle, et al.. Regional anesthesia with noninvasive ventilation for shoulder surgery in a patient with severe chronic obstructive pulmonary disease: a case report. A & A Case Reports, Wolters Kluwer, 2017, 8 (10), pp.261-264. ⟨10.1213/XAA.0000000000000488⟩. ⟨hal-02135092⟩

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