Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2008
Practice GuidelineASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine.
Neurologic complications associated with regional anesthesia and pain medicine practice are extremely rare. The ASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine addresses the etiology, differential diagnosis, prevention, and treatment of these complications. This Advisory does not focus on hemorrhagic and infectious complications, because they have been addressed by other recent ASRA Practice Advisories. The current Practice Advisory offers recommendations to aid in the understanding and potential limitation of neurologic complications that may arise during the practice of regional anesthesia and pain medicine.
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Reg Anesth Pain Med · Sep 2008
Practice patterns related to block selection, nerve localization and risk disclosure: a survey of the American Society of Regional Anesthesia and Pain Medicine.
We aimed to identify current clinical practice patterns among members of the American Society of Regional Anesthesia and Pain Medicine (ASRA) members that relate to complications of regional anesthesia (RA). ⋯ Based on a 22% response rate, our survey suggests that the risks of RA most commonly disclosed to patients by ASRA members are benign while severe complications of RA are far less commonly disclosed. There is little agreement among ASRA members regarding their perceived incidence of complications following RA.
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A peripheral nerve or spinal cord injury is a rare but significant complication of regional anesthesia. Evaluation of acute nerve injury includes a focused history and examination to localize the lesion. Confirmatory testing should include electromyography and appropriate imaging. ⋯ The prognosis for cauda equina or spinal cord lesions is more guarded. Recovery from these is commonly incomplete. Early diagnosis and intervention is the key to preventing catastrophic neurological outcomes.