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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes drop in carbon dioxide levels after placing shoulder block?

A 34-year old, woman in good health except for asthma which is under treatment. Is scheduled for shoulder surgery. Has block placed in shoulder and while she is being put under her CO2 drops to 62, has to be intubated and surgery is canceled. What would cause C02 level to drop and patient have to be intubated and surgery canceled.
Thu, 8 Apr 2021
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General & Family Physician 's  Response
Hi,

I think the question should be O2 saturation instead of CO2 level. The sudden drastic drop in O2 saturation may be due to interscalene brachial plexus block, rarely causing a symptomatic paralysis of phrenic nerve and hence, causing hemi diaphragmatic paresis, thus, dyspnea resulting in low saturation of oxygen. However, in your case, anxiety or panic symptoms may be a cause causing alteration in respiratory rate and hence, low saturation of oxygen. You are advised to talk about this to your doctor before going for shoulder surgery / shoulder block next time.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Satnarain Bansal, General & Family Physician
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What causes drop in carbon dioxide levels after placing shoulder block?

Hi, I think the question should be O2 saturation instead of CO2 level. The sudden drastic drop in O2 saturation may be due to interscalene brachial plexus block, rarely causing a symptomatic paralysis of phrenic nerve and hence, causing hemi diaphragmatic paresis, thus, dyspnea resulting in low saturation of oxygen. However, in your case, anxiety or panic symptoms may be a cause causing alteration in respiratory rate and hence, low saturation of oxygen. You are advised to talk about this to your doctor before going for shoulder surgery / shoulder block next time. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Satnarain Bansal, General & Family Physician