Comments on: “Phrenic Nerve Block, the Rescue Management for Pneumothorax after Retrolaminar Block”

Kartik Sonawane,Tuhin Mistry,Elayavendhan Kuppusamy,Joseph Abraham Poonuraparampil

doi:10.4038/slja.v29i2.8735

Abstract

The Sri Lankan Journal of Anaesthesiology is the official journal of the College of Anaesthesiologists of Sri Lanka. It publishes clinical investigations, research articles, audits, case reports, review articles and CME articles relating to anaesthesiology, critical care and pain. It is published bi annually in January and June. Sri Lankan Journal of Anaesthesiology is included on DOAJ and Scopus.

Highlights

Dear Editor, We read with interest the recent publication by Mishra et al in the June 2020 issue of Sri Lankan Journal of Anaesthesiology.[1]
Intraoperative chest auscultation or ultrasound scanning could have helped in the early diagnosis of pneumothorax in a patient of chronic obstructive pulmonary disease (COPD) with a rise in end-tidal CO2 and airway pressures
Phrenic nerve lies very close to the brachial plexus at the level of cricoid cartilage or sixth cervical vertebra.[4]. Administration of such large volumes of local anaesthetic may result in inadvertent brachial plexus block and/or other complications

Summary

Introduction

Dear Editor, We read with interest the recent publication by Mishra et al in the June 2020 issue of Sri Lankan Journal of Anaesthesiology.[1]. Intraoperative chest auscultation or ultrasound scanning could have helped in the early diagnosis of pneumothorax in a patient of chronic obstructive pulmonary disease (COPD) with a rise in end-tidal CO2 and airway pressures. 4. Phrenic nerve block (PNB) causes an ipsilateral hemi-diaphragmatic palsy (HDP), resulting in loss of cephalocaudal movements of the diaphragm during respiration. PNB, especially in a COPD patient, may not be an ideal choice, for the management of pneumothorax.

Results

Conclusion