Neurologic injury from axillary block anesthesia

Three cases of severe permanent neurologic injury following axillary block anesthesia from a single hand surgery practice are presented, along with the results of a survey regarding complications of axillary block anesthesia sent to the membership of the American Society for Surgery of the Hand. This survey resulted in 800 replies. Of respondents, 171 (21%) had seen a major neurologic complication at some time in their practice. Minor, transient complications were reported by 521 respondents (65%). Only 232 respondents (29%) reported no major or minor neurologic complications in their practice. These cases and the results of this survey suggest that serious permanent neurologic injury following axillary block anesthesia, although rare, may be more frequent than previously believed. Transient neurologic problems following axillary block are common but generally do not lead to long-term problems. Permanent neurologic injury following axillary block anesthesia is a devastating complication and should be carefully considered when determining the preferred anesthesia for an individual patient.