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[Peripheral neurologic complications of brachial plexus blocks]
M E Gentili1, J P Wargnier, F C Caillon
1Service d'Anesthésie-Réanimation, Clinique Sainte-Anne, Gourin.
Cahiers D'Anesthesiologie
|January 1, 1990
Summary
Peripheral nerve block anesthesia can cause nerve injury due to needle trauma, toxic effects, or ischemia. Prompt diagnosis and treatment, including potential surgery, are crucial for managing these postanesthetic neuropathies.
Area of Science:
- Anesthesiology
- Neurology
Context:
- Peripheral nerve blocks are common anesthetic procedures.
- Nerve injury is a potential complication of these blocks.
Purpose:
- To review the etiologic factors, symptoms, and management of nerve injury following peripheral nerve blocks.
- To highlight the importance of careful technique to prevent nerve damage.
Summary:
- Key causes of nerve injury include direct needle trauma, intraneural injection, local anesthetic toxicity (especially with epinephrine), and ischemic injury.
- Symptoms range from paresthesia and dysesthesia to motor weakness and paralysis.
- Effective and immediate clinical analysis is essential for management and medicolegal reasons.
- Treatment may involve specific therapies or surgical exploration (external neurolysis).
Impact:
- Emphasizes the need for meticulous technique during nerve blocks, such as avoiding intraneural injections and using appropriate needles and solutions.
- Informs clinicians on recognizing and managing postanesthetic neuropathies.
- Contributes to patient safety and potentially reduces medicolegal complications.