Diaphragm-sparing nerve blocks for shoulder surgery: essentials of our current understanding

The authors aim to address the challenges of managing shoulder surgery in patients with pulmonary disease by reviewing diaphragm-sparing nerve block techniques as alternatives to traditional interscalene brachial plexus blocks. They discuss the innervation of the shoulder, the concept of hemidiaphragmatic paralysis, and evaluate the evidence for various diaphragm-sparing strategies while highlighting existing knowledge gaps that warrant further research.