Complications of regional anesthesia and acute pain management.

Perioperative nerve injuries are recognized as a complication of regional anesthesia. Although rare, studies suggest the frequency of complications is increasing. Risk factors include neural, traumatic injury during needle or catheter placement, infection, and choice of local anesthetic solution. Neurologic injury due to pressure from improper patient positioning, tightly applied casts or surgical dressings, and surgical trauma are often attributed to regional anesthetic. Body habitus and preexisting neurologic dysfunction may also contribute. The safe conduct of regional anesthesia involves knowledge of patient, anesthetic, and surgical risk factors. Early diagnosis and treatment of reversible etiologies are critical to optimizing neurologic outcome.