Is it time to start some thinking about pressure monitoring during peripheral nerve blocks?
Nerve injury is a rare, but the most dreaded complication of regional anaesthesia. Fortunately, most incidents of neurological deficits resulting from the regional anaesthesia are temporary and resolve over a period. A small percent of cases have lasting sequelae. The aetiology of nerve injury is multifactorial. Direct trauma to the nerve with the rheumatoid arthritis needle, local anaesthetic (LA) neurotoxicity, ischaemic injury secondary to pressure and volume of LA or added vasoconstrictors1 and intraneural injection of the LA have been suggested as the possible causes.2