Neurological Complications After Regional Anesthesia: Contemporary Estimates of Risk

Abstract

Our review suggests that the rate of neurological complications after central nerve blockade is <4:10,000, or 0.04%. The rate of neuropathy after PNB is <3:100, or 3%. However, permanent neurological injury after RA is rare in contemporary anesthetic practice.

Histological confirmation of needle tip position during ultrasound-guided interscalene block: a randomized comparison between the intraplexus and the periplexus approach

“…Nonetheless, our results suggest that the periplexus technique may be superior and that further study is warranted. When these data are interpreted, with the recognition that interscalene brachial plexus block is associated with higher rates of neurological complications compared with other peripheral nerve blocks, 25 we recommend that clinicians consider a periplexus technique rather than an intraplexus technique for interscalene brachial plexus block, especially if the success rate for both techniques is similar.…”

A “swing room” model based on regional anesthesia reduces turnover time and increases case throughput

“…However, consistent with our experience and the results of others is the finding that these regional anesthesia techniques are associated with high degrees of patient satisfaction and are safe. 2,3,16 At present, we are planning to develop a comprehensive regional anesthesia database for our centre that would include this type of data.…”

Ultrasound-guided regional anesthesia for upper limb surgery

“…In fact, up to 8% of all neurological symptoms reported on the seventh postoperative day have been attributed to interscalene blocks performed for shoulder surgery. 10 A recent study indicates that interscalene blocks are associated with the highest incidence (close to 3%) of transient neurological symptoms among all peripheral nerve blocks; 11 however, it is difficult to distinguish the relatively frequent neurological sequelae due to surgery from those caused by the anesthetic technique.…”

“…10 Une étude récente indique que le bloc interscalénique est associé à la plus forte incidence de lésions neurologiques transitoires parmi tous les blocs nerveux périphériques, soit près de 3 %. 11 Cependant, il est difficile de départager les séquelles neurologiques relativement fréquentes occasionnées par la technique chirurgicale à celles occasionnées par la technique anesthésique. Récemment, une étude comportant un grand nombre de patients a comparé l'utilisation des blocs supraclaviculaires et interscaléniques comme technique d'anesthésie pour des chirurgies de l'épaule.…”