Exparel Interscalene Block & Respiratory Failure

Document Type

Conference Proceeding

Publication Date

10-12-2025

Abstract

We present a 75-year-old female with COPD having a right shoulder arthroplasty. Preoperative interscalene blocks are the standard of care for post-operative pain management of shoulder replacements at our institution. Following an uneventful interscalene block and surgery, the patient was noted to be wheezing, tachypneic, diaphoretic, and anxious. She was given Ativan for presumed anxiety and became unresponsive and hypoxic. Imaging ruled out a pulmonary embolism but showed an elevated right hemidiaphragm. Despite reversal with flumazenil, the patient required intubation and mechanical ventilation. With this case, we will discuss patient and surgical considerations for interscalene blocks and alternative regional techniques for shoulder surgeries.

Comments

American Society of Anesthesiologists, The Anesthesiology Meeting, October 10-14, 2025, San Antonio, TX

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