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We thank Drs Cros-Campoy and Sala-Blanch1 for their interest in our recent trial.2 As stated in our article, the goal of the current and previous randomized trials was to find a diaphragm-sparing alternative to interscalene brachial plexus block for patients with known pulmonary pathology undergoing shoulder surgery.2–5 Consequently, protection of the phrenic nerve and preservation of hemidiaphragmatic function remain the chief concerns. Any discomfort related to “dense distal motor and sensory blockade of the upper limb” becomes secondary. We respectfully highlight the fact that, in 2003, when he had to provide surgical anesthesia for a patient with severe asthma undergoing proximal humeral fracture repair, Dr Sala-Blanch combined infraclavicular block with (posterior) suprascapular nerve block.6 He did not appear concerned about said dense sensorimotor block of the upper extremity.