Regional Anesthesia Complications and Contraindications

Anesthesiol Clin. 2024 Jun;42(2):329-344. doi: 10.1016/j.anclin.2023.11.013.

Abstract

Regional anesthesia has a strong role in minimizing post-operative pain, decreasing narcotic use and PONV, and, therefore, speeding discharge times. However, as with any procedure, regional anesthesia has both benefits and risks. It is important to identify the complications and contraindications related to regional anesthesia, which patient populations are at highest risk, and how to mitigate those risks to the greatest extent possible. Overall, significant complications secondary to regional anesthesia remain low. While a variety of different regional anesthesia techniques exist, complications tend to fall within 4 broad categories: block failure, bleeding/hematoma, neurological injury, and local anesthetic toxicity.

Keywords: Hematoma; Nerve injury; Neuraxial anesthesia; Rebound pain; Regional anesthesia.

Publication types

  • Review

MeSH terms

  • Anesthesia, Conduction* / adverse effects
  • Anesthesia, Conduction* / methods
  • Anesthetics, Local / adverse effects
  • Contraindications
  • Contraindications, Procedure
  • Hematoma / etiology
  • Hematoma / prevention & control
  • Hemorrhage / prevention & control
  • Humans
  • Nerve Block / adverse effects
  • Nerve Block / methods
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control

Substances

  • Anesthetics, Local