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Regional Nerve Blocks—Best Practice Strategies for Reduction in Complications and Comprehensive Review

  • Other Pain (A Kaye and N Vadivelu, Section Editors)
  • Published:
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Abstract

Purpose of Review

Understanding the etiologies of the complications associated with regional anesthesia and implementing methods to reduce their occurrence provides an opportunity to foster safer practices in the delivery of regional anesthesia.

Recent Findings

Neurologic injuries following peripheral nerve block (PNB) and neuraxial blocks are rare, with most being transient. However, long-lasting and devastating sequelae can occur with regional anesthesia. Risk factors for neurologic injury following PNB include type of block, injection in the presence of deep sedation or general anesthesia, presence of existing neuropathy, mechanical trauma from the needle, pressure injury, intraneural injection, neuronal ischemia, iatrogenic injury related to surgery, and local anesthetic neurotoxicity.

Summary

The present investigation discusses regional blocks, complications of regional blocks, risk factors, site-specific limitations, specific complications and how to prevent them from happening, avoiding complications in regional anesthesia, and the future of regional anesthesia.

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Authors and Affiliations

  1. Department of Anesthesiology, University of Florida, PO Box 100254, Room 2036, Gainesville, FL, 32610, USA

    Erik M. Helander

  2. Medical University of South Carolina, Charleston, SC, 29425, USA

    Aaron J. Kaye

  3. Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave, New Orleans, LA, 701123, USA

    Aaron J. Kaye & Lauren A. Bonneval

  4. Department of Anesthesiology, LSU Health Sciences Center, 1542 Tulane Ave, New Orleans, LA, 70112, USA

    Matthew R. Eng

  5. Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave, New Orleans, LA, 70112, USA

    Patrick I. Emelife & Mark W. Motejunas

  6. LSU Health Sciences Center New Orleans, 2020 Gravier Street, 5th Floor, New Orleans, LA, 70112, USA

    Lauren A. Bonneval

  7. LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA

    Justin A. Terracciano

  8. Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA

    Elyse M. Cornett

  9. Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave, New Orleans, LA, 70112, USA

    Alan D. Kaye

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  1. Erik M. Helander
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  9. Alan D. Kaye
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Correspondence to Elyse M. Cornett.

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Conflict of Interest

Erik M. Helander, Aaron J. Kaye, Matthew R. Eng, Patrick I. Emelife, Mark W. Motejunas, Lauren A. Bonneval, Justin A. Terracciano, and Elyse M. Cornett declare no conflict of interest. Alan D. Kaye serves on the Speakers Bureau of Depomed and Merck.

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Helander, E.M., Kaye, A.J., Eng, M.R. et al. Regional Nerve Blocks—Best Practice Strategies for Reduction in Complications and Comprehensive Review. Curr Pain Headache Rep 23, 43 (2019). https://doi.org/10.1007/s11916-019-0782-0

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