Horner's syndrome following ultrasound-guided inter-Scalene Brachial Plexus Block for Diagnostic Arthroplasty: Case Report of a Rare Complication

Abstract

Interscalene brachial plexus block is a common technique for postoperative pain management after shoulder surgery. While generally safe and effective, it can lead to unintended complications, including Horner's syndrome. This case report describes a 30-year-old female who developed transient left-sided Horner's syndrome on postoperative day 2 following an ultrasound-guided ISB with continuous infusion of ropivacaine for diagnostic shoulder arthroscopy. The patient did not have any pre-operative systemic disease or co-morbidities such as diabetes, hypertension etc. Despite the initial uneventful course, the patient developed ptosis and miosis on the second postoperative day. The patient was managed by discontinuation of the anaesthetic medication .The symptoms resolved spontaneously after discontinuing the local anaesthetic infusion on the third day. This case highlights the importance of recognizing and managing this potential complication of interscalene block, particularly when using continuous infusion techniques.

Keywords: Diagnostic arthroscopy, Inter-scalene block, local anaesthetic toxicity, Horner’s syndrome