Respiratory Failure After Supraclavicular Nerve Block in a Patient With a Contralateral Brachial Plexus Injury

A patient with prior left-sided brachial plexus trauma and associated left phrenic nerve paralysis subsequently developed transient respiratory failure after a contralateral supraclavicular nerve block. Her known left phrenic nerve palsy secondary to her index brachial plexus injury was rediscovered during the workup of her acute respiratory distress, which resulted in an emergent intensive care unit admission.The paralysis of her right phrenic nerve at the time of left-sided regional anesthesia was identified as the etiology of near-complete bilateral diaphragmatic paralysis and respiratory failure.