The main purpose of this article is to present the neurological complications of regional anesthesia. Our analysis may help clinicians determine when regional anesthesia can be administered safely and in which patients it needs additional precautions. Regional anesthesia has a major role in anesthesia practice. Here, we focus especially on the most common neurological complications: epidural hematoma, post-anesthesia headaches, and peripheral nerve function defect. We investigated risk factors of these states and propose ways of reducing the risks. This work is based on the available literature and the authors' experience. The research process involved using relevant keywords in various electronic databases, resulting in the selection of 32 articles published between 1989 and 2022. This manuscript provides an overview and analysis of the existing literature related to neurological complications of regional anesthesia. We believe that our article provides up-to-date information on the most common regional anesthesia complications, emphasizing differences concerning children and pregnant women and provides important guidance for clinicians in preparing for and performing anesthesia.
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http://dx.doi.org/10.12659/MSM.940399 | DOI Listing |
A A Pract
January 2025
From the Department of Anesthesiology, Sheba Medical Center, Ramat Gan, Israel.
This case series reviews surgeries involving elderly patients with femoral neck fractures on apixaban who underwent spinal anesthesia (SA) within 72 hours of their last dose. Despite patients being on anticoagulation, no neurological complications occurred, suggesting SA may be practical in cases where the benefits of timely surgery outweigh the potential risks, including apixaban discontinuation for a period of less than the recommended 72 hours with detectable levels of the drug remaining in the plasma. Quantitative apixaban measurements offered useful anticoagulation status insights, though safe thresholds remain undefined.
View Article and Find Full Text PDFA A Pract
January 2025
From the Department of Anesthesia, Perioperative and Pain Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts.
After vascular puncture and catheterization, arteries can have many complications that impede blood flow such as vasospasm, thrombosis, and emboli generation, among other complications. Treatment depends on severity of ischemic symptoms and can range from as mild as applying local heat packs to surgical thrombectomy. We present a case of digital ischemia secondary to vascular puncture that was successfully treated with a supraclavicular nerve block, resulting in the vascular surgery team canceling an emergent surgery.
View Article and Find Full Text PDFEClinicalMedicine
January 2025
Department of Anesthesia and Intensive Care Unit, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier, Montpellier, CEDEX 5, France.
Background: Patients with obesity are at high-risk of extubation failure. Discrepancies were found in the results of recent randomized controlled trials (RCTs) regarding the roles of noninvasive ventilation (NIV), high flow nasal cannula (HFNC) and conventional oxygen therapy (COT) to prevent extubation failure in critically ill patients with obesity.
Methods: In this systematic review and network meta-analysis, we searched MEDLINE, Cochrane Center Register of Controlled Trials and Web of Science from 1 January 1998 to 1 July 2024 for RCTs evaluating noninvasive respiratory support therapies (NIV, HFNC, COT, NIV + HFNC) after extubation in critically ill adults with obesity.
Patient Saf Surg
January 2025
Department of Trauma, University Hospital Zurich, Raemistrasse 100, Zurich, 8091, Switzerland.
Introduction: Regional anesthesia increases in popularity in orthopaedic surgery. It is usually applied in elective surgeries of the extremities. The aim of this study was to assess indication of the use of general anesthesia in the surgical treatment of distal radius fractures.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Background: High-frequency, high-intensity transcutaneous electrical nerve stimulation (HFHI TENS, i.e. 80 Hz and 40-60 mA) is an effective, fast-acting pain relief modality after elective surgery, offering pain relief within 5 min.
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