caa a22 4500 445374497 CHVBK 20180317142958.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00540-010-1076-1 doi (NATIONALLICENCE)springer-10.1007/s00540-010-1076-1 Severe stridor and marked respiratory difficulty after right-sided supraclavicular brachial plexus block [Elektronische Daten] [Sohan Solanki, Amit Jain, Jeetinder Makkar, Sapna Nikhar] Brachial plexus block is commonly used for upper limb surgery. Although the procedure is safe, it may be associated with some life-threatening complications. We performed right-sided supraclavicular brachial plexus block for below-elbow amputation in a 45-year-old female. At completion of the block the patient developed marked respiratory difficulty with audible inspiratory stridor. Although SpO2 decreased to 82% initially, it was increased to 100% by continuous positive airway pressure with a face mask. On conventional direct laryngoscopy, the left vocal cord was found to be in the midline position and the right vocal cord was in the paramedian position. The trachea was intubated and surgery proceeded without any other complication. Postoperative indirect laryngoscopy revealed that the left vocal cord was fixed, whereas the right vocal cord was mobile, and diagnosis of pre-existing incomplete left vocal cord paralysis was made. This clinical report is to emphasize the importance of thorough pre-operative evaluation of the vocal cord in patients who have undergone any surgical procedure or radiation treatment of the neck before planning for brachial plexus block. If such an evaluation cannot be obtained, an alternative technique, for example axillary approach, should be preferred. Japanese Society of Anesthesiologists, 2010 Brachial plexus nationallicence Recurrent laryngeal nerve nationallicence Vocal cord nationallicence Solanki Sohan Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India aut Jain Amit Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India aut Makkar Jeetinder Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India aut Nikhar Sapna Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India aut Journal of Anesthesia Springer Japan 25/2(2011-04-01), 305-307 0913-8668 25:2<305 2011 25 540 https://doi.org/10.1007/s00540-010-1076-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-010-1076-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Solanki Sohan Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Jain Amit Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Makkar Jeetinder Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Nikhar Sapna Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/2(2011-04-01), 305-307 0913-8668 25:2<305 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer