Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Review Case Reports
Case report: ropivacaine neurotoxicity at clinical doses in interscalene brachial plexus block.
To describe a case of ropivacaine toxicity following an ultrasound guided interscalene block and discuss the possible mechanisms involved. ⋯ Local anesthetic toxicity is an uncommon but well documented complication of regional anesthesia. Careful monitoring and preparedness for managing complications during the conduct of regional anesthesia cannot be overemphasized. Experience from this case suggests that local anesthesia toxicity can happen within safe dose limits and without intravascular placement despite careful attention to needle and catheter placement, fractionated dosing and frequent aspirations.
-
The purpose of this narrative review is to summarize the evidence derived from randomized controlled trials (RCTs) regarding approaches and techniques for lower extremity nerve blocks. ⋯ Published reports of RCTs provide evidence to formulate limited recommendations regarding optimal approaches and techniques for lower limb anesthesia. Further well-designed and meticulously executed RCTs are warranted, particularly in light of new techniques involving ultrasonographic guidance.