Regional anaesthesia or block is a well-established technique for making a limb numb so that surgery could take place without causing pain. It may be employed in isolation in which case the patient stays awake or in combination with general anaesthesia in which case the patient is put to sleep for the duration of the procedure. In addition it also serves as a very effective form of postoperative pain relief leading to less or no opioid requirement as well as a shorter hospital stay.

Nerve injuries following a block are fortunately rare but the complications could be devastating for both the patients and the anaesthetist. The true incidence is difficult to determine. The incidence of mild transient paraesthesia or neurological deficit might be as high as 10% but permanent nerve damage might occur in only 1-2 cases for every 10,000 blocks.

When should I seek help?

  • If there is neuropathic pain (electric shock, shooting, burning).
  • If there is persistent numbness or paralysis of the limb beyond the expected time of resolution of the anaesthetic agent used.
  • If the numbness and/or weakness have remained static. In other words, there is no change or progression with time.
  • If there is loss of sweating in the limb. 

Key message

Nerve injuries following regional anaesthesia are rare. However prompt recognition and action will ensure the disability from the nerve injury is kept to the minimum.


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