title: Complications associated with 27 031 ultrasound-guided axillary brachial plexus blocks: a web-based survey of 36 French centres.
abstract: BACKGROUND
  Ultrasound guidance improves the efficacy of peripheral nerve blocks, reducing performance time and local anaesthetic doses. It should also reduce the risk of systemic toxicity of local anaesthetic and nerve injuries.
  
  
  OBJECTIVE
  The primary objective of this prospective study was to estimate the incidence of immediate complications related to ultrasound-guided axillary brachial plexus blocks in a multicentre observational cohort.
  
  
  METHODS
  Prospective multicentre observational study.
  
  
  METHODS
  Thirty-six French centres participated in the study between 2009 and 2012.
  
  
  METHODS
  A total of 27 031 axillary brachial plexus blocks were recorded.
  
  
  METHODS
  The study objective, the incidence of immediate complications related to ultrasound-guided axillary brachial plexus blocks (intravascular injection of local anaesthetic and neurological deficit at hospital discharge), was based on data collected by anaesthesiologists through a web-based case report form.
  
  
  METHODS
  Incidence of immediate complications related to ultrasound-guided axillary brachial plexus blocks.
  
  
  RESULTS
  Of 27 031 blocks performed, the incidence of systemic toxicity of local anaesthetic was very low at 1.5 per 10 000, and the overall incidence of postoperative neurological symptoms was 0.37 per 10 000.
  
  
  CONCLUSIONS
  We have reported a large series of ultrasound-guided axillary brachial plexus blocks in a multicentre study. Our results confirm the low incidence of local anaesthetic systemic toxicity and postoperative neurological complications as previously described.
authors.affiliation: From the Service d'Anesthésie Réanimation Chirurgicale 2, CHU Rennes, Université de Rennes 1 (CE, HB), Centre d'Investigation Clinique INSERM CIC-0203, Rennes (EO), Service d'Anesthésie Réanimation Hôpital Saint-Antoine AP-HP, Université Paris, Paris (FM-M), Anesthésie-Réanimation Clinique de Fontaine, Fontaine Lès Dijons (YC), Anesthésie-Réanimation, Clinique La Francilienne, Pontault-Combault, France (J-JR).
authors.forename: Claude
authors.initials: C
authors.lastname: Ecoffey
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Oger
authors.forename: Florence
authors.initials: F
authors.lastname: Marchand-Maillet
authors.forename: Yann
authors.initials: Y
authors.lastname: Cimino
authors.forename: Jean-Jérome
authors.initials: JJ
authors.lastname: Rannou
authors.forename: Hélène
authors.initials: H
authors.lastname: Beloeil
mesh_terms: D000328:Adult; D065527:Brachial Plexus Block / Q000009:adverse effects*; D015331:Cohort Studies; D003625:Data Collection / Q000379:methods*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018084:Ultrasonography, Interventional / Q000009:adverse effects*