Regional anaesthesia sub-algorithm
| Classification | Description | Number | ||
|---|---|---|---|---|
| E/S* | BrPl† | Oph‡ | ||
| Total sample included *E/S, epidural or spinal block cases (98 epidural, 91 spinal, 4 combined, 3 caudal); †BrPl, brachial plexus block cases (12 axillary block, 5 interscalene block, 3 supraclavicular block, 1 not stated); ‡Oph, ophthalmic block cases (9 peribulbar, 9 retrobulbar, 5 not stated). | ||||
| §A total of 16 blood patches were required after dural puncture. | ||||
| Ask the patient (6 cases) | Wrong patient | 1 | – | – |
| Wrong side | – | 2 | 2 | |
| Failed block | – | – | 1 | |
| Local anaesthetic toxicity (11 cases) | Fitting | 2 | – | |
| Nausea | 1 | – | – | |
| Other effects | 8 | |||
| Assess level of block (30 cases) | Overdose, n = 20 | 3 | ||
| Total spinal | 14 | – | – | |
| High block/prolonged recovery | 3 | – | – | |
| Underdose/failed block, n = 10 | ||||
| Incorrect infusion rate | 3 | – | – | |
| Communication error | 1 | – | – | |
| Not stated | 6 | – | – | |
| Catheter/needle problems (76 cases) | ||||
| Inadvertent intravascular placement or injection (20 cases) | 7 | 13 | – | |
| Fitting (5 brachial plexus blocks) | ||||
| Other effects (8 brachial plexus blocks) | ||||
| Inadvertent intrathecal placement or injection (35 cases) | ||||
| Inadvertent subarachnoid injection | 1 | – | – | |
| Dural puncture (17 with headache§; 10 without headache; 6 not stated) | 33 | – | – | |
| Migration of epidural catheter | 1 | – | – | |
| Inadvertent subdural placement or injection (3 cases) | ||||
| Subdural drug effect | 3 | – | – | |
| Blocked/kinked/split catheter, or catheter pulled out (4 cases) | 4 | – | – | |
| Trauma (7 cases) | Pneumothorax | – | 1 | – |
| Epidural haematoma | 1 | – | – | |
| Bloody spinal tap | 2 | – | – | |
| Haematoma/haemorrhage after ophthalmic block | – | – | 2 | |
| Corneal damage | – | – | 1 | |
| Infection (2 cases) | Epidural abscess | 1 | – | – |
| Positive catheter tip culture | 1 | – | – | |
| Pain (5 cases) | Dural puncture headache after spinal block§ | 4 | – | – |
| Backache after epidural block | 1 | – | – | |
| Consequences of sensory/motor blockade (1 case) | Fall post-spinal block | 1 | – | – |
| Miscellaneous | Hypothermia after epidural block | 2 | – | – |
| Remaining (6 cases) | Other | – | – | 4 |