Anesthesia of The Brachial Plexus - Complications


As with any procedure involving disruption of the integrity of the skin, brachial plexus block can be associated with infection or bleeding. In people who are using anticoagulant agents, there is a greater risk of complications related to bleeding.

Complications associated with brachial plexus block include intra-arterial or intravenous injection, which can lead to local anesthetic toxicity. This may be characterized by serious central nervous system problems such as epileptic seizure, central nervous system depression, and coma. Cardiovascular effects of local anesthetic toxicity include slowing of the heart rate and impairment of its ability to pump blood through the circulatory system, which may lead to circulatory collapse. In severe cases, cardiac dysrhythmia, cardiac arrest and death may occur. Other rare but serious complications from brachial plexus block include pneumothorax and persistent paresis of the phrenic nerve.

Complications associated with interscalene and supraclavicular blocks include inadvertent subarachnoid or epidural injection of local anesthetic, which can result in respiratory failure.

Because of the close proximity of the lung to the brachial plexus at the level of the clavicle, the complication most often associated with this block is pneumothorax — with a risk as high as 6.1%. Further complications of supraclavicular block include subclavian artery puncture, and spread of local anesthetic to cause paresis of the stellate ganglion, the phrenic nerve and recurrent laryngeal nerve.

Read more about this topic:  Anesthesia Of The Brachial Plexus

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