Australia: Results of a Multicenter Registry of Regional Anesthesia

Chapter

Key Points

  • The primary goal of this registry was to determine the quality and safety of our current routine practice of peripheral nerve blockade.

  • This chapter presents a summary of results from the Australasian Regional Anaesthesia Collaboration and the Australian and New Zealand Registry of Regional Anaesthesia.

  • Results of the Australasian Regional Anesthesia Collaboration showed an incidence of 0.4/1000 peripheral nerve blocks for neurologic injury related to the block (out of 8189 blocks). Incidence of local anesthetic toxicity was 0.98/1000.

  • Results of the Australian and New Zealand Registry of Regional Anaesthesia revealed incidences of peripheral nerve block-related late and long-term neurological deficits were 0.6 and 0.3 per 1000 blocks, respectively. Incidence of local anesthetic toxicity was 0.87/1000.

  • Patients with postoperative neurologic features were more likely to have a cause unrelated to peripheral nerve blockade.

  • The results presented from this registry demonstrate that the incidence of serious permanent neurologic complications attributable to peripheral nerve block is rare.

  • The risk of local anesthetic systemic toxicity was reduced with ultrasound guidance and increased body weight. Local anesthetic dosage and site of injection were predictors of local anesthetic systemic toxicity.

  • Incidence of post-block respiratory impairment was relatively higher (3.4/1000). Other complications, such as wrong-site blocks and pneumothorax, while rare, were nevertheless captured by the registry.

Keywords

Local anesthetic dosage Adverse effects Nerve blocks Registries Ultrasonography Peripheral nervous system 

Abbreviations

ARAC

Australasian Regional Anaesthesia Collaboration

AURORA

The Australian and New Zealand Registry of Regional Anaesthesia

LAST

Local anesthetic systemic toxicity

PNB

Peripheral nerve blockade

PNI

Postoperative Nerve Injury

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Anaesthesia and Acute Pain MedicineSt. Vincent’s Hospital, MelbourneMelbourneAustralia
  2. 2.Faculty of Medicine, Dentistry and Health SciencesMelbourne Medical School, University of MelbourneParkvilleAustralia

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