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Neural Complications of Axillary Plexus Block

  • D. Selander
Part of the Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine book series (A+I, volume 158)

Abstract

Neural complications following axillary plexus blocks have a reported incidence of less than 2%, while the corresponding figure for supraclavicular plexus blocks varies between 2.2 and 7.5%. This difference may depend on trauma to the nerves during the search for paresthesias, [1,3] which is obligatory in supraclavicular blocks but not in axillary blocks. To test this idea, we studied the incidence of neural complications after axillary blocks performed with or without searching for paresthesias [8] (Table 1). In one group of 290 patients, paresthesias were used to locate the axillary plexus, in the other group of 243 patients, the pulsations of the axillary artery were used to ensure correct placement of the injection needle within the neurovascular sheath. Signs of postblock nerve lesion were found in eight patients (2.8%) in the paresthesia group and in two patients (0.8%) in the nonparesthesia, or artery group, in both of which there were reports of accidental paresthesias during the block procedure. This difference supports the impression that searching for paresthesia may injure nerves and thus increase the risk of postblock nerve lesions.

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References

  1. 1.
    Bonica JJ (1954) The management of pain, 2nd edn. Lea and Febiger, Philadelphia, pp 227–228Google Scholar
  2. 2.
    Key A, Retzius G (1876) Studien in der Anatomie des Nervensystemes und des Bindegewebes. Samson and Wallin, StockholmGoogle Scholar
  3. 3.
    Moore DC (1955) Complications of regional block. Thomas, Springfield, pp 112–118Google Scholar
  4. 4.
    Lundborg G (1970) Ischemic nerve injury. Scand J. plastic reconstr. Surg [Suppl] 6: 3Google Scholar
  5. 5.
    Lundborg G (1975) Structure and function of the intraneural microvessels as related to trauma, edema formation and nerve function. J Bone Joint Surg 57A: 938PubMedGoogle Scholar
  6. 6.
    Selander D, Dhunér KG, Lundborg G (1977) Peripheral nerve injury due to injection needles used for regional anaesthesia. Acta Anaesthesiol Scand 21: 182PubMedCrossRefGoogle Scholar
  7. 7.
    Selander D, Sjöstrand J (1978) Longitudinal spread of intraneurally injected local anesthetics. Acta Anaesthesiol Scand 22: 622PubMedCrossRefGoogle Scholar
  8. 8.
    Selander D, Edshage S,Wolf T(1979a) Paresthesiae or no parestesiae? Acta Anaesthesiol Scand 23: 27PubMedCrossRefGoogle Scholar
  9. 9.
    Selander D, Brattsand R, Lundborg G, Nordborg C, Olsson Y (1979b) Local anesthetics: Importance of mode of application, concentration and adrenaline for the appearance of nerve lesions. Acta Anaesthesiol Scand 23: 127PubMedCrossRefGoogle Scholar
  10. 10.
    Selander D, Karlsson L, Månsson LG, Svanvik J (1980) Adrenaline, neural ischemia and local anesthetic nerve toxicity. 7th World congress of anaesthesiologists, Hamburg, paper no 777Google Scholar
  11. 11.
    Waksman B (1961) Experimental study of diphteric polyneuritis in the rabbit and guinea pig. III. The blood-nerve barrier in the rabbit. J Neuropathol Exp Neurol 20: 35PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1984

Authors and Affiliations

  • D. Selander

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