Case Report

Workup and Management of Persistent Neuralgia following Nerve Block

Table 2

Possible mechanisms for perioperative nerve injury [12].

Risk factorsPatientAnestheticSurgical

Preoperative(i) Preexisting neuropathies
(ii) Old age
(iii) Chemotherapy
(iv) Vascular disease
(v) Diabetes mellitus
(vi) Multiple sclerosis
(vii) Inflammatory or autoimmune disorders

Intraoperative(i) Needle trauma
(ii) Local anesthetic toxicity
(iii) Toxicity related to injectate/adjuvants
(iv) Hypotension
(v) Improper limb positioning (pressure trauma, nerve stretching)
(i) Tourniquet pressure
(ii) Direct trauma during surgery (transection, stretch, compression)