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Type: Journal article
Title: Preliminary results of the Australasian Regional Anaesthesia Collaboration: a prospective audit of more than 7000 peripheral nerve and plexus blocks for neurologic and other complications
Author: Barrington, M.
Watts, S.
Gledhill, S.
Thomas, R.
Said, S.
Snyder, G.
Tay, V.
Jamrozik, K.
Citation: Regional Anesthesia and Pain Medicine, 2009; 34(6):534-541
Publisher: W B Saunders
Issue Date: 2009
ISSN: 1098-7339
Statement of
Barrington Michael J., Watts Steve A., Gledhill Samuel R., Thomas Rowan D., Said Simone A., Snyder Gabriel L., Tay Valerie S. and Jamrozik Konrad
Abstract: Background and Objectives: Peripheral nerve blockade is associated with excellent patient outcomes after surgery; however, neurologic and other complications can be devastating for the patient. This article reports the development and preliminary results of a multicenter audit describing the quality and safety of peripheral nerve blockade. Methods: From January 2006 to May 2008, patients who received peripheral nerve blockade had data relating to efficacy and complications entered into databases. All patients who received nerve blocks performed by all anesthetists during each hospital's contributing period were included. Patients were followed up by phone to detect potential neurologic complications. The timing of follow-up was either at 7 to 10 days or 6 weeks postoperatively, depending on practice location and time period. Late neurologic deficits were defined as a new onset of sensory and/or motor deficit consistent with a nerve/plexus distribution without other identifiable cause, and one of the following: electrophysiologic evidence of nerve damage, new neurologic signs, new onset of neuropathic pain in a nerve distribution area, paresthesia in relevant nerve/plexus distribution area. Results: A total of 6950 patients received 8189 peripheral nerve or plexus blocks. Of the 6950 patients, 6069 patients were successfully followed up. In these 6069 patients, there were a total of 7156 blocks forming the denominator for late neurologic complications. Thirty patients (0.5%) had clinical features requiring referral for neurologic assessment. Three of the 30 patients had a block-related nerve injury, giving an incidence of 0.4 per 1000 blocks (95% confidence interval, 0.08-1.1:1000). The incidence of systemic local anesthetic toxicity was 0.98 per 1000 blocks (95% confidence interval, 0.42-1.9:1000). Conclusions: These results indicate that the incidence of serious complications after peripheral nerve blockade is uncommon and that the origin of neurologic symptoms/signs in the postoperative period is most likely to be unrelated to nerve blockade.
Keywords: Peripheral Nerves; Humans; Nervous System Diseases; Amides; Lidocaine; Bupivacaine; Anesthetics, Local; Ultrasonography, Interventional; Treatment Outcome; Clinical Protocols; Transcutaneous Electric Nerve Stimulation; Nerve Block; Prospective Studies; Safety; Medical Audit; Australasia
Rights: Copyright © 2009 by American Society of Regional Anesthesia and Pain Medicine
RMID: 0030016821
DOI: 10.1097/AAP.0b013e3181ae72e8
Appears in Collections:Public Health publications

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