I were in my final year of residency. I took a presentation on the complications of regional anesthesia. It is a very tough subject. There is so much that can go wrong with this topic. I had to show that I had learnt and could bear the burden the pressure of cross questioning just to be able to probe learn this magnificent field.

1. Complications of Regional
Anesthesia
Dr. Muhammad Muneeb Riaz
PGR Anesthesia/ICU, JHL

2. Regional Anesthesia
• Neuraxial Anesthesia
• Peripheral Nerve Blocks
• Scalp
• Upper limb
• Trunk
• Lower limb

3. Drugs Used
• Local Anesthetics
• Adjuvants

4. Complications
• Related to procedure
• Related to drugs

5. Complications related to procedure
• Ineffective/ partial, incomplete block
• Hematoma
• Nerve damage
• Positioning complications
• Surrounding visceral damage like pneumothorax
• Expected side effects, like Horners' syndrome after stellate ganglion
block
• Dissatisfaction of the patient

6. What is neuraxial anesthesia?
• Spinal
• Epidural
• Caudal

7. Complications related to Drugs
• Local Anesthesia Systemic Toxicity
• Factors contributing
• Drug properties
• Site of block
• Dose and concentration
• Speed of injection
• Adjuvants used or not like adrenaline

8. • Patient factors:
• Age
• Weight
• Pregnancy in females
• Volume status

9. Complications of Neuraxial Anesthesia
• Failure/ incomplete block
• Hypotension
• Bradycardia
• Nausea and vomiting
• High spinal
• Total spinal
• Infection
• Spinal abscess
• Blood vessel injury
• Back ache

10. Local Anesthesia Systemic Toxicity
• Occurs due to high concentration of local anesthetic in blood.