Is chronic obstructive pulmonary disease (COPD) a contraindication to performing an interscalene block?

Is chronic obstructive pulmonary disease (COPD) a contraindication to performing an interscalene block?

COPD is a relative contraindication to performing an interscalene block. Ipsilateral phrenic nerve paralysis occurs in all patients who receive an interscalene block, which will result in a 25% decrease in pulmonary function. Therefore, patients who cannot tolerate a 25% decrease in pulmonary function should not be considered for this block.

Other contraindications to regional anesthesia include: patient refusal, infection at the site of needle insertion, anatomic anomalies, allergies to local anesthetics used, and severe coagulopathies.