Complications associated with peripheral nerve blocks: lessons from the ASA Closed Claims Project.

摘要

New techniques and regional blocks have brought a renewed enthusiasm for the use of regional anesthesia for surgery. The use of ultrasound-guided anesthesia has become widespread. Meetings on regional anesthesia are focusing on new or increased use of regional blocks such as the transverse abdominus plane (TAP), ilioinguinal or iliohypogastric, lumbar plexus, psoas, and paravertebral blocks, and also continuous peripheral nerve catheters in the ambulatory setting. Some of the benefits of these changes in regional anesthesia that have been reported include greater success of blocks, improved efficiency, and improved analgesia and patient satisfaction. Typically, new procedural techniques provide both new benefits and new risks. We previously reported on complications associated with peripheral nerve blocks from the American Society of Anesthesiologists (ASA) Closed Claims Database for blocks performed between 1980 and 1999. To provide a more current assessment of liability associated with regional anesthesia, and to evaluate whether or not these new trends in regional anesthesia have been associated with any new complications, we reanalyzed the database for regional anesthesia claims occurring in 1990 or later.