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Journal of Hand Surgery (British and European Volume)
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Articles

Regional Anaesthesia and Subsequent Long-Term Pain

L. WEEKS
A. BARRY
T. WOLFF
J. FIRRELL
L. SCHEKER

From the Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, Kentucky, USA

Correspondence: Thomas W. Wolff, MD, Christine M. Kleinert Institute for Hand and Microsurgery, 1 Medical Center Plaza, Suite 850, 225 Abraham Flexner Way, Louisville, Kentucky 40202, USA.

The incidence of long-term pain (between 1 and 48 weeks and at 2 year follow-up) unrelated to the surgical site following either regional brachial plexus or general anaesthesia was determined. In 834 patients with regional anaesthesia, the incidence (11.1%) was significantly higher than in the 86 patients with general anaesthesia (3.6%; P =0.03). The incidence of pain was not significantly different among four common techniques of positioning the needle tip in the axillary sheath (9.9 to 11.1%). Parascalene blocks had a slightly but not significantly higher rate (16.3%). A regional re-block was not associated with a higher incidence when compared to those blocked only once. A more distal local re-block was associated with a higher incidence of pain (23%). 2 years post-operatively, 0.5% of patients had pain related to the regional block. A significant proportion of patients developed some long-lasting post-operative pain following regional brachial plexus anaesthesia, although ultimate morbidity was minimal.

Journal of Hand Surgery (British and European Volume), Vol. 19, No. 3, 342-346 (1994)
DOI: 10.1016/0266-7681(94)90086-8
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