Summary
In this review an effort has been made to highlight the most common and most important complications of regional anaesthesia and the most up-to-date treatment of these problems. For more complete information one should refer to the bibliography and major textbooks on this subject.
Résumé
Dans cette revue nous avons essayé de mettre en lumière les complications les plus courantes et les plus importantes de l’anesthésie régionale et d’indiquer les traitements les plus appropriés de ces problèmes. Pour des informations plus complètes l’on devrait se référer à la bibliographie et aux monographies sur le sujet.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Koller C. The use of cocaine for producing anaesthesia of the eye. (Translated and reprinted) Lancet 1884; 2: 990–2.
Woods JH, Downs DA. The psychopharmacology of cocaine. Drug use in America: problem in perspective, Appendix Vol. 1: Patterns and consequences of Drug use. Washington: U.S. Government Printing Office 1973; 116–39.
Mayer E. The toxic effects following the use of local anaesthetics. JAMA 1924; 82: 876–85.
Bier A. Experiments regarding the cocainization of the spinal cord. Zietschrift fur Chirurgie 51: 361–368; 1899. Translated in Classical file. Survey of Anesthesiology 1962; 6: 352–8.
Kennedy F, Effron AS, Perry G. Grave spinal cord paralyses caused by spinal anaesthesia. Surg Gynccol Obstet 1950; 91: 385–98.
Cope RW. The Woolley and Roe Case. Woollcy and Roe versus Ministry of Health and Others Anaesthesia 1954; 9: 249–70.
Dripps RD, Vandam LD. Long term follow-up of patients who received 10,098 spinal anaesthetics. Failure to discover major neurological sequelae. JAMA 1954; 156: 1486–91.
The Experts Opine. Survey of Anesthesiology 1990; 34: 125–30.
Rao TLK, El-Etr AA. Anticoagulation following placement of epidural and subarachnoid catheters: an evaluation of neurologic sequelae. Anesthesiology 1981; 55: 618–20.
McIntyre JWR. Monitoring regional anesthesia. Int J Clin Monit Comp 1990 (in press).
Caplan RA, Wand RJ, Posner K, Cheney FW. Unexpected cardiac arrest during spinal anesthesia: a closed claims analysis of predisposing factors. Anesthesiology 1988; 68: 5–11.
Covino BG, Vassallo. Local anesthetics. Mechanisms of action and clinical use. New York, San Francisco, London. Grune and Stratton 1976.
Ravindran RS, Bond VK, Tasch MD et al. Prolonged neural blockade following regional anesthesia with 2-chloroprocainc. Anesth Analg 1980; 59: 447–51.
Massey Dawkins CJ. An analysis of the complications of extradural and caudal block. Anaesthesia 1969; 24: 554–63.
Plevak DJ, Lindstromberg JW, Danielson DR. Paresthesia vs nonparesthesia — the axillary block anesthesiology 1983; 59: A216.
Scott DB. Toxic effects of local anaesthetic agents on the central nervous system. Br J Anaesth 1986; 58: 732–5.
Morishima HO, Pederson H, Finster M et al. Is bupivacainc more cardiotoxic than lidocaine? Anesthesiology 1983; 59: A409.
Clarkson CW, Hondeghem LM. Mechanism for bupivacaine depression of cardiac conduction: fast block of sodium channels during the action potential with slow recovery from block during diastole. Anesthesiology 1985; 62: 396–405.
Scott DB, Lee A, Fagan D et al. Acute toxicity of ropivacaine compared with that of bupivacaine. Anesth Analg 1989; 69: 563–9.
Leighton BL, Norris MC, DeSimone CA et al. The air test as a clinically useful indicator of intravenously placed epidural catheters. Anesthesiology 1990; 73: 610–3.
Kozody R, Ready LB, Barsa JE, Murphy TM. Dose requirement of local anaesthetic to produce grand mal seizure during stellate ganglion block. Can Anaesth Soc J 1982; 29: 489–91
Kasten GW, Martin ST. Bupivacaine cardiovascular toxicity. Comparison of treatment with bretylium and lidocaine. Anesth Analg 1985; 64: 911–6.
Lund PC, Cwik JC. Modern trends in spinal anaesthesia. Can Anaesth Soc J 1968; 15: 118–34.
Noble AB, Murray JG. A review of complications of spinal anaesthesia with experiences in Canadian teaching hospitals from 1959 to 1969. Can Anaesth Soc J 1971; 18: 5–17.
Massey Dawkins CJ. An analysis of the complications of extradural and caudal block. Anaesthesia 1969; 24: 554–63.
Nunn JF, Utting JE, Brown JrBR. General Anaesthesia 5th ed. London; Butterworths & Co. Ltd. 1989; 1106–12.
Plevak DJ, Lindstromberg JW, Danielson DR. Paresthesia vs nonparesthesia — the axillary block. Anesthesiology 1983; 59: A216.
Selander D, Edshage S, Wolff T. Paresthesiae or no paresthesiae: nerve lesions after axillary blocks. Acta Anaesthesiol Scand 1979; 23: 27–33.
Massey Dawkins CJ. An analysis of the complications of extradural and caudal block. Anaesthesia 1969; 24: 554–63.
Kroll DA, Caplan RA, Posner K et al. Nerve injury associated with anesthesia. Anesthesiology 1990; 73: 202–7.
Winnie AP. Plexus Anesthesia. Philadelphia, Toronto: W.B. Saunders Co. 1983; 242–8.
Forrestner J. (personal communication)
Shanker KB, Palker NV, Nishkala R. Paraplegia following epidural potassium chloride. Anaesthesia 1985; 40: 45–7.
Vandam LD, Dripps RD. Long-term follow-up of patients who received 10,098 spinal anaesthesias. JAMA 1956; 161: 586–91.
Mihic DN. Postspinal headache and relationship of needle bevel to longitudinal durai fibers. Reg Anesth 1985; 10: 76–81.
Ready LB, Cuplin S, Haschke RH et al. Spinal needle determinants of rate of transdural fluid leak. Anesth Analg 1989; 69: 457–60.
Szeinfeld M, Ihmeidan IH, Moser MM et al. Epidural blood patch: evaluation of the volume and spread of blood injected into the epidural space. Anesthesiology 1986; 64: 820–2.
Quanor H, Corby M. Extradural blood path — why delay? Br J Anaesth 1985; 57: 538–40.
Moore DC, Bridenbaugh DL. Spinal (subarachnoid) block. JAMA 1966; 195: 123–8.
May LG, Bennett A, Lane AL et al. Effect of high spinal anesthesia on the cardiac output of normal and hypertensive patients. Am J Med 1949; 7: 251–2.
Caplan RA, Wand RJ, Posner K, Cheney FW. Unexpected cardiac arrest during spinal anesthesia: a closed claims analysis of predisposing factors. Anesthesiology 1988; 68: 5–11.
Brown E, Elman DS. Postoperative backache. Anesth Analg 1961; 40: 683–5.
Tuohy EB. Continuous spinal anesthesia: a new method utilizing a urethral catheter. Surg Clin N Am 1945; 25: 834–40.
Hurley RJ, Lambert DH. Continuous spinal anesthesia with a microcatheter technique: preliminary experience. Anesth Analg 1990; 70: 97–102.
Farrar MD, Scheybani M, Nolte H. Upper extremity block. Effectiveness and complications. Reg Anesth 1981; 6: 133–4.
Merrill DG, Brodsky JB, Hentz RV. Vascular insufficiency following axillary block of the brachial plexus. Anesth Analg 1981; 80: 162–4.
Restelli L, Pineiroli D, Conoscente F et al. Insufficient venous drainage following axillary approach to brachial plexus blockade. Br J Anaesth 1984; 56: 1051–3.
Ott B, Neuberger L, Frey HP. Obliteration of axillary artery after axillary block. Anaesthesia 1989; 44: 773–4.
Kvalheim L, Reiestad F. Interpleural catheter in the management of postoperative pain. Ancsthcsiology 1984; 61: A231.
Stromskag KE, Minor B, Stein PA. Side effects and complications related to interpleural analgesia: an update. Acta Anaesthesiol Scand 1990; 34: 473–7.
Cousins MJ, Bridenbaugh PO. Neural Blockade 2nd ed. Philadelphia: J.B. Lippincott Co. 1988; 861–83.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Finucane, B.T. Regional anaesthesia: complications and techniques. Can J Anaesth 38 (Suppl 1), R3–R16 (1991). https://doi.org/10.1007/BF03008430
Issue Date:
DOI: https://doi.org/10.1007/BF03008430