Neurological complications following central neuraxial blocks: are there predictive factors?

Severe complications such as spinal epidural haematoma and an array of adverse neurological events leading to temporary or permanent disability have been ascribed to central neuraxial blocks. Infections (meningitis, abscesses), chemical injuries and very rarely cerebral ischaemia or haemorrhage, or both, have also been ascribed directly or indirectly to spinal and/or epidural anaesthesia. Some case reports, and very few retrospective studies, have focused their attention on the fact that central nerve blocks can cause, albeit rarely, permanent damage to the spinal cord or nerve roots, or both.

Mepivacaine: update on an evergreen local anaesthetic.

Many local anaesthetics are presently available for clinical use. The choice of a particular agent for a particular regional anaesthetic is based mainly on its clinical and pharmacological features. Besides these, safety of drugs and the knowledge of side effects associated with their use can play a major role, since serious complications can be related to local anaesthetics administration.