Brachial plexus injury is a potential complication of a
brachial plexus block or vessel
puncture. It results from direct
needle trauma, neurotoxicity of
injection agents and
hematoma formation. The neurological presentation may range from
minor transient pain to severe sensory disturbance or motor loss with poor recovery. The management includes
conservative treatment and surgical exploration. Especially if a
hematoma forms, it should be removed promptly. Comprehensive
knowledge of
anatomy and adept skills are crucial to avoid nerve
injuries. Whenever possible, the
patient should not be heavily sedated and should be encouraged to immediately inform the doctor of any experience of
numbness/
paresthesia during the
nerve block or vessel
puncture.