Premium
Paresthesiae or No Paresthesiae? Nerve Lesions after Axillary Blocks
Author(s) -
Selander D.,
Edshage S.,
Wolff T.
Publication year - 1979
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1979.tb01417.x
Subject(s) - medicine , mepivacaine , anesthesia , axillary artery , surgery , local anesthetic , etiology , paresis , plexus , nerve block , anesthetic , artery
Seeking paresthesiae when performing a peripheral nerve block may increase the risk of post‐anesthetic neurological sequelae. To test this hypothesis, we prospec‐tively followed two groups of patients who underwent hand surgery with an axillary block. In one group, the axillary plexus was located by actively seeking paresthesiae; in the other, pulsations of the axillary artery indicated an adequate position of the injection needle. Mepivacaine 10 mg/ml, with or without adrenaline, was used. The study included 533 patients, 290 in the paresthesia group and 243 in the artery group. Although unintentional, paresthesiae were elicited in 40% of patients in the artery group. Postanesthetic nerve lesions were seen in ten patients, eight in the paresthesia group and two in the artery group, all of whom had been blocked by mepivacaine with adrenaline. Symptoms varied between light paresthesiae lasting a few weeks, and severe paresthesiae, ache and paresis lasting more than 1 year. The etiology suspected was needle and perhaps injection trauma to the nerves during blocking. We conclude that whenever possible nerve blocks should be performed without searching for paresthesiae.