{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T21:32:01Z","timestamp":1767821521578,"version":"3.49.0"},"reference-count":5,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,30]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>A man in his 70s with Parkinson\u2019s disease underwent urgent below-elbow amputation for gangrenous sepsis. A right supraclavicular brachial plexus catheter was placed for postoperative analgesia. Shortly after tracheal extubation, he developed acute hypercapnic respiratory failure due to ipsilateral hemidiaphragmatic paresis, requiring urgent tracheal re-intubation and a brief period of mechanical ventilation. Following cessation of the local anaesthetic infusion, diaphragmatic function returned and he was successfully re-extubated. A reduced-dose supraclavicular infusion was later reintroduced after multidisciplinary review, without recurrence. This case highlights an infrequent but clinically significant complication of supraclavicular block and emphasises diagnostic evaluation, risk stratification and safe reintroduction of regional analgesia.<\/jats:p>","DOI":"10.1136\/bcr-2025-268077","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:46:03Z","timestamp":1767789963000},"page":"e268077","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Respiratory failure after tracheal extubation secondary to phrenic nerve blockade and acute right hemidiaphragmatic paresis following supraclavicular brachial plexus anaesthesia"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-2717","authenticated-orcid":false,"given":"Muzzammil","family":"Ali","sequence":"first","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahima","family":"Islam","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jubeyr","family":"Ahmed","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"2026010704455549000_19.1.e268077.1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.4274\/TJAR.2025.241648","article-title":"Assessment of the Incidence of Hemi-Diaphragmatic Paralysis Following Infraclavicular and Supraclavicular Approaches for Brachial Plexus Block: A Randomized Controlled Study","volume":"53","author":"Parameswari","year":"2025","journal-title":"TJAR"},{"key":"2026010704455549000_19.1.e268077.2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen229"},{"key":"2026010704455549000_19.1.e268077.3","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2022-104264"},{"key":"2026010704455549000_19.1.e268077.4","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1136\/rapm-2024-105728","article-title":"Acute reversal of respiratory distress after a preoperative single-shot interscalene nerve block","volume":"50","author":"Meulemans","year":"2024","journal-title":"Reg Anesth Pain Med"},{"key":"2026010704455549000_19.1.e268077.5","doi-asserted-by":"crossref","first-page":"e237","DOI":"10.1016\/j.jemermed.2020.03.023","article-title":"Case Study of Phrenic Nerve Paralysis: \u201cI Can\u2019t Breathe!\u201d","volume":"58","author":"Doyle","year":"2020","journal-title":"J Emerg Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:46:03Z","timestamp":1767789963000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":5,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,7]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-268077"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268077","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}