A 63-year-old male, a left-handed woodworking craftsman with diabetes and a BMI of 37, presented for an outpatient surgery arthroscopic repair of a left shoulder labral tear sustained after a fall that did not respond to conservative treatment. The patient and his daughter stated that he was “bullied” into a nerve block. There was no written consent for the regional block in the medical record and no documentation of a verbal discussion with consent. The patient was sedated with midazolam (total 4 mg) and fentanyl 100 mcg for the block. A left-sided/“supraclavicular-interscalene” block was performed using ultrasound guidance with a 21-gauge B-echo needle without pain or paresthesia. 50 ml of bupivacaine 0.375% with epinephrine 1:300,000 was used for the block with the doses given incrementally. The patient then received an unremarkable general anesthetic for surgical repair. The OR time was 50 minutes.

The patient recalls burning pain in the shoulder...

You do not currently have access to this content.