Debilitating chronic pain syndromes after presumed intraneural injections

Abstract

This report presents seven patients with severe disability established at the time of a peripheral nerve block. In most of the cases, the injection was administered as a routine procedure by an experienced anesthesiologist. The patient histories suggest that the condition, which can be resistant to all treatment, in most cases could have been avoided if careful attention had been given to the occurrence of pain during the nerve block. It is likely that the risk of devastating iatrogenic disability can be minimized if a few basic principles are respected during the administration of peripheral nerve blocks.

Le nerf radial doit être anesthésié avant le nerf cubital pendant un blocage du plexus brachial au travers du canal huméral

“…9,10 Constant evolution of the number of procedures and unknown mechanisms underline the importance of a rigorous block sequence, particularly during a multi-stimulation technique. This is emphasized by the poor outcome of chronic neurological disabilities following peripheral nerve blocks, 11 and the fact that no study has demonstrated that neurostimulation reduces neurological complication rates. 12 Finally we must emphasize the importance of the local anesthetic used.…”

To Compare the Efficacy & Safety of Nerve Stimulation Method with Ultrasound Guidance along With Nerve Stimulation alone for Supraclavicular Brachial Plexus Block

“…Symptoms mostly are moderate and transitory with a tendency of spontaneous recovery within times related to nerve regeneration and repair mechanisms. Interestingly, Kaufman et al [24 ] reported a series of seven patients suffering from severe, debilitating chronic pain states after peripheral nerve blocks. However, in the present study there was one case of neuropraxia and weakness in radial nerve distribution of the blocked arm post operatively.…”

Comparison Between Conventional Technique and Ultrasound Guided Supraclavicular Brachial Plexus Block in Upper Limb Surgeries

“…14 Symptoms mostly are moderate and transitory with a tendency of spontaneous recovery within times related to nerve regeneration and repair mechanisms. Interestingly, Kaufman et al, 15 reported a series of seven patients suffering from severe, debilitating chronic pain states after peripheral nerve blocks. In all seven cases, painful paraesthesia were elicited at the time of nerve block, be they voluntary or accidental with a progress to severe chronic pain condition.…”