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Auditory, Ocular, and Facial Complications of Central Neural Block: A Review of Possible Mechanisms
  1. C. J. E. Day, M.B., Ch.B., M.R.C.P., F.R.C.A. and
  2. L. E. Shutt, M.B., Ch.B., F.R.C.A.
  1. Sir Humphry Davy Department of Anaesthesia, Bristol Royal Infirmary, Bristol, England
  1. Reprint requests: C. J. E. Day, M.B., Sir Humphry Davy Department of Anaesthesia, Bristol Royal Infirmary, Bristol, England.


Background and Objectives The purpose of this review is to draw together a collection of uncommon complications of central neural block that affect the cranial nerves. There have been a small number of case reports, some of which have included a possible mechanism of the nerve dysfunction, but there is no prior review that collected them together and discussed the possible mechanisms.

Methods Published case reports were identified by searching Medline of the British Medical Association and the Silver Platter CD-ROM library. In addition, the Medical Defence Union and Medical Protection Society were contacted to find cases that were unpublished but the subject of medical negligence lawsuits.

Results The authors collected these cases together to increase awareness of alarming complications. If such cases are recognized for what they are, then the prognosis is good; however, delayed diagnosis can make them a cause of great anxiety and possible litigation.

Conclusions Increased awareness of these complications can decrease the likelihood of litigation by early diagnosis and explanation. Their mechanisms are not fully understood but the likely possibilities have been discussed. Further work is needed to establish the incidence of these problems, as it is likely that many cases are not diagnosed and not reported.

  • epidural analgesia
  • spinal analgesia
  • complications
  • cranial nerves

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