http://www.nurse-anesthesia.org/ en Wed, 19 Jun 2013 18:47:13 GMT vBulletin 60 http://www.nurse-anesthesia.org/images/styles/BlueDemon/misc/rss.png http://www.nurse-anesthesia.org/ http://www.nurse-anesthesia.org/showthread.php/16817-Peripheral-regional-anesthesia-in-patients-under-general-anesthesia?goto=newpost Thu, 13 Jun 2013 03:14:38 GMT Peripheral regional anesthesia in patients under general anesthesia : Risk assessment with respect to parasthesia, injection pain and nerve... Peripheral regional anesthesia in patients under general anesthesia : Risk assessment with respect to parasthesia, injection pain and nerve damage.]

Authors

Kessler P, Steinfeldt T, Gogarten W, Schwemmer U, Büttner J, Graf BM, Volk T.



Journal

Anaesthesist. 2013 Jun 5. [Epub ahead of print] Article in German.
Affiliation

Abteilung für Anästhesiologie, Intensiv- und Schmerzmedizin, Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstr. 2, 60528, Frankfurt, Deutschland, p.kessler@friedrichsheim.de.

Abstract

Nerve injury after peripheral regional anesthesia is rare and is not usually permanent. Some authors believe that inducing peripheral nerve blocks in patients during general anesthesia or analgosedation adds an additional risk factor for neuronal damage. This is based on published case reports showing that there is a positive correlation between paresthesia experienced during regional anesthesia and subsequent nerve injury. Therefore, many sources recommend that regional nerve blocks should only be performed in awake or lightly sedated patients, at least in adults. However, there is no scientific basis for this recommendation. Furthermore, there is no proof that regional anesthesia performed in patients under general anesthesia or deep sedation bears a greater risk than in awake or lightly sedated patients. Currently anesthesiologists are free to follow personal preferences in this matter as there is no good evidence favoring one approach over the other. The risk of systemic toxicity of local anesthetic agents is not higher in patients who receive regional anesthesia under general anesthesia or deep sedation. Finally, in children and uncooperative adults the administration of peripheral nerve blocks under general anesthesia or deep sedation is widely accepted.




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