ABSTRACT
Interscalene bracheal plexus block has became a popular method of anesthesia for surgical operation on the upper extremities. Possible complications are subarachnoid block, epidural block, phrenic nerve block, vagus or recurrent laryngeal nerve block, sympathetic nerve block, intravascular injection. But reported complications has been few and generally without prolonged effects. The following describes a patient who developed signs and symptoms suggestive of inadvertent phrenic nerve block and epidural anesthesia as complications of interscalene bracheal plexus block The complications were attributed to using of inferomedially directed 5 cm needle and then additional blind block of the brachial plexus with 5 or 6 times. We emphasize that if the appropriate length of needle and technique are not used, phrenic nerve paralysis and serious complications including total spinal or epidural block can occur as a result of a medially misdirected needle.