Complications of peripheral nerve blocks

Abstract

Complications of PNBs are uncommon but often feared by both the patient and the anesthesiologist. The mechanism of neurologic complications is multifactorial and may include needle trauma, toxicity of local anesthetics, nerve ischemia or the combination of these factors. Excessive resistance (pressure) and pain on injection may be predictive of neurologic complications and should be avoided. Other preventable causes of neurologic complications include compressive hematoma, tourniquet ischemia, malpositioning, compartment syndrome and surgical intervention itself.