Anesth Pain Med.  2009 Oct;4(4):368-371.

Unrecognized intraneural injection as a possible cause of nerve injury associated with axillary block : A case report

• Jung W
• Kim SS

Abstract

A 71-year-old man who had a laceration on his right fifth finger underwent an emergency explorative operation under brachial plexus block that was performed by using transaxillary artery technique.During axillary block, no elicitation of paresthesia was presented.Postoperatively he complained numbness on his right arm along the dermatome of 7th cervical nerve distribution.Two weeks later the evidence of nerve injury was found on EMG and NCV carried by the department of neurology. Observing closely for another two weeks, the symptoms and signs were gradually improved.On 42nd postoperative day, the patient complained no neurologic problems and the findings of EMG and NCV returned to normal.Considering the method of anesthesia, operation time, tourniquet time and patient position, we conclude that the direct needle injury and intraneural injection during axillary block are the highly suggestive causes of nerve injury.

Keyword

Axillary block; Direct needle injury; Elicitation of paresthesia; Intraneural injection; Numbness

MeSH Terms

Aged
Anesthesia
Arm
Arteries
Brachial Plexus
Emergencies
Fingers
Humans
Hypesthesia
Lacerations
Needles
Neurology
Paresthesia
Tourniquets