Complications of regional anesthesia.
OBJECTIVE
The use of regional anesthesia, either alone or as an adjunct to general anesthesia, is at an all-time high. Demonstrated benefits include reduced side effects, more efficient use of facilities and enhanced patient satisfaction with the improved postoperative pain relief. New advances in equipment, techniques and medications have been incorporated over the past 10 years, and especially over the last 2 years. As the number of practitioners and procedures increase, the number of complications may rise as well.


RESULTS
The specific issues of nerve damage, treatment of local anesthetic toxicity with lipid solutions and prevention of wrong-sided procedures are examined with special reference to recent publications.


CONCLUSIONS
Specific needle shapes, appropriate pharmacologic resuscitation from intravascular injection of local anesthetics and institutional procedures to positively identify patients and the correct block location are all part of a strategy to minimize the occurrence of adverse outcomes and to mitigate the consequences of those adverse events when they do occur. More importantly, these are changes that can be instituted immediately with minimal expense to the institution and great benefit to the patient.
Greensmith
J Eric
JE
Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17036, USA.
Murray
W Bosseau
WB
D000765:Anesthesia, Conduction / Q000009:adverse effects* / Q000295:instrumentation / Q000639:trends; D000779:Anesthetics, Local / Q000009:adverse effects*; D003327:Coronary Disease / Q000139:chemically induced; D006801:Humans; D019300:Medical Errors; D010243:Paralysis / Q000209:etiology; D012640:Seizures / Q000139:chemically induced; D020196:Trauma, Nervous System / Q000209:etiology*
D000779:Anesthetics, Local