Article Text
Abstract
Background and Aims Incidences of neurological injuries after US guided peripheral nerve blocks are extremely rare, transient neurological deficits as transient paresthesia might be as high as 8–10% in immediate days and permanent nerve damage is 1.5/10,000.(1,2, 3,) The latest estimates of PNB-related temporary nerve symptoms suggest an incidence of 2.2% at 3 months, 0.8% at 6 months, and 0.2% at 1 yr.(4) The aim of this audit was to Identify the incidence of nerve injury related to single shot US guided PNBs.
Methods Following taking ethical approval from corporate quality and audit committee at department of anesthesiology-HGH, retrospective data of patients who received single shot US-guided PNBs in the block room at HGH was collected in a datasheet over a period of 6months from 1st April 2021. Each patient was followed in person at 24 hours and through the electronic patient’s record up to 6 weeks. For the purpose of this audit, any new sensory, motor deficit post PNB except preop neurological injury was followed up to 6 weeks period.
Results Demographics of the 207 patients are presented in images1 whereas the types of blocks performed are in Image 2. We identified 20 cases had preoperative motor or sensory deficit. There is no block-related nerve injury at 24 hours and 6 weeks.
Conclusions We conclude that the incidence of nerve injury following US guided single shot PNBs is extremely low if we follow strict measures of pressure while injection, tip of needle location and use of short bevel blunt needle with or without nerve stimulator use.