Complete brachial plexus palsy after total shoulder arthroplasty done withinterscalene block anesthesia

Background and Objectives: This report illustrates that brachial plexus pal sy can result from either interscalene block or total shoulder arthroplasty . It is often impossible to determine which procedure caused the deficit: t herefore, we believe the focus should be placed on treatment of the neurolo gic deficit. This report provides a suggested algorithm for diagnosis and t reatment of postprocedure brachial plexus palsy. Methods: Interscalene block was used as the operative anesthetic for our pa tient's total shoulder arthroplasty. Complete brachial plexus palsy was dia gnosed postoperatively. Results: The patient's postoperative treatment and recovery are described. Conclusions: Proper diagnosis and treatment of postprocedure brachial plexu s palsy may improve recovery of function. Several precautions may reduce th e likelihood of brachial plexus palsy following interscalene block for tota l shoulder arthroplasty.