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Abstract
In this article, we will discuss the pathophysiology of peripheral nerve injury in
anaesthetic practice, including factors which increase the susceptibility of nerves
to damage. We will describe a practical and evidence-based approach to the management
of suspected peripheral nerve injury and will go on to discuss major nerve injury
patterns relating to intra-operative positioning and to peripheral nerve blockade.
We will review the evidence surrounding particular strategies to reduce the incidence
of peripheral nerve injury during nerve blockade, including nerve localisation methods,
timing of blocks, needle techniques and design, injection pressure-monitoring and
local anaesthetic and adjunct choice.