An attempt to insert a supra-scapular block by an anaesthetist was unsuccessful, and surgery was conducted under GA instead. Postoperatively the patient developed shortness of breath, required supplemental oxygen then collapsed. Chest x-ray revealed a pneumothorax. A chest drain was  inserted by the ENT consultant.

Commentary

Although supra-scapular blocks are associated with fewer complications than interscalene brachial plexus blocks, pneumothorax is a recognised complication of both. Whenever there is new onset respiratory or cardiovascular compromise following such blocks, pneumothorax must be excluded/ rapidly treated.