oa Southern African Journal of Anaesthesia and Analgesia - How safe are regional techniques? Evidence from large studies with big data : SASA main conference



The issue of the safety of regional anaesthetic techniques can only be addressed by a careful examination of the complications that may occur. These injuries can be caused by a variety of mechanisms, including sharp and blunt trauma, drug neurotoxicity (including the wrong drug), compressive injury (notably spinal haematomas), stretch injury and nerve ischaemia. The nature of the regional technique is a major determinant of the risk of injury, and neuraxial techniques have been studied to a far greater extent than those involving peripheral nerve blockade. The major problem in studying the safety of regional techniques is that the standard tools of randomised controlled trials and meta-analysis are inappropriate for a proper assessment of rare events, such as neurological injury. Most of the references to adverse effects, particularly those associated with peripheral procedures, are to be found as single case reports, and thus are difficult to assess using standard trial methodology.


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