Possible allergic reaction after outpatient surgery

A 54-year-old woman presented to the ED with complaints of a possible allergic reaction. She reported feeling well immediately after surgery but then experienced a sudden onset of difficulty swallowing, excessive sweating, hoarseness, right facial swelling, and right eye irritation. After consulting the patient's surgeon and the institution's anesthesiology department about the supraclavicular nerve block and the patient's symptoms, clinicians determined that the most likely cause of the patient's Horner presentation and dysphonia was sympathetic uptake of the ropivacaine.