Complications of regional anaesthesia.

Purpose of review: In recent years, ultrasound-guided regional anaesthesia has become more widely available. Despite this, only around one fifth of consultant anaesthetists in the UK feel able to perform all the commonly used blocks. One significant reason for this is concern over the perceived complications of regional anaesthesia. This review provides up-to-date estimates of risk and considers issues raised in the latest literature on the topic.

Recent findings: Recent developments include guidelines for local anaesthetic toxicity, a novel method to classify block failure, and recommendations regarding team communication and use of safety devices. Regional anaesthesia continues to be safe, with recent case reports extending its applicability to higher risk situations. Examples include spinal anaesthesia at thoracic levels and in significant aortic stenosis.

Summary: Widespread adoption of safety technology and use of pre-existing and novel communication tools will continue to optimise the safety of regional anaesthesia. Standardisation of the reporting of complications of regional anaesthesia could improve this further.