Neurologic deficit after peripheral nerve block: what to do?

Regional nerve injury is a recognized complication of plexus anesthesia. Nerve damage after regional anesthesia is the most frightening complication for the patient, the anesthetist and the surgeon too. In order to limit possible medico-legal issues, the anesthetist has to follow an algorithm. The indication and information obtained from the ultrasonography, the sudomotor test, the electromyogram, the elctroneuromyogram and the evoked potentials are discussed. The principles to avoid anesthetic-related nerve damage during regional anesthesia are given. Finally treatment and surveillance, after nerve damage has occurred, are explained.