Complications of Peripheral Nerve Blockade

Study Summary

This article describes the structure, and results of a large, web-based, prospective database designed to capture quality and safety data on peripheral nerve blockade (PNB). It also contains details on the clinical pathway used for followup and assessment of suspected neurologic injury. A structured form was provided on the website for data entry and capture, as well as recommended pathways for patient followup, and assessment in the case of suspected complications. The database is maintained by the Australasian Regional Anaesthesia Collaboration and can be accessed at www.regional.anaesthesia.org.au.

Between January 2006 and January 2007, data was collected from 2 hospitals; from January 2007 onwards, a web-based database was established that allowed collection of data from an additional 7 hospitals. Of 6950 patients entered into the database, 6069 were successfully followed up. These 6069 patients received a total of 7156 blocks. Thirty patient (0.5%) had clinical features prompting assessment for neurologic injury. Three of these met the criteria for PNB-related injury, giving an incidence of 0.04% for nerve injury due to PNB. Local anesthetic toxicity occurred in 8 patients; in 4 of these patients, ultrasound was used, and all patients received axillary block. The results are consistent with previous reports of the incidence of complications following PNB. Given that these complications are rare, a database such as this is a valuable resource. We look forward to further reporting of results from the ARAC, and we encourage all block practitioners to participate in the project.