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 |