Prevention and treatment of neurological complications of the upper extremity following local anesthesia

P. Dagrenat, Luca Vaienti, M. Merle, A. Spaite, L. Lanfranchi

Research output: Contribution to journalArticlepeer-review


The most common neurological complications following local anesthesia involve interruption of nerve continuity (axonotmesis and neurotmesis), formation of hematoma, or compression induced by tourniquet or by prolonged malposition on the operating table. Most post block neurological complications are observed subsequent to paresthesia triggered by penetration or injection. Paresthesia are classified as benign or as levels 3 and 4, which can result in nerve damage. An EMG should be routinely performed when there is no spontaneous resolution of nerve damage three weeks after the anesthetic procedure. The differential diagnosis based on examination of the patient will be confirmed by subsequent clinical and electromyographical progression. Most importantly, preventive measures should include meticulous technique and careful advancement of the injection needle; no injection should be made if there is a paresthesia or if there is resistance to the injection. Treatment of minor complications may require only peripheral analgesics but in more severe cases where progression is unfavorable, surgery may be indicated.

Original languageEnglish
Pages (from-to)104-113
Number of pages10
JournalTechniques in Regional Anesthesia and Pain Management
Issue number2
Publication statusPublished - Apr 2003

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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