Ojum S. (1)
Anesthesia nerve injuries remain a significant concern in perioperative care due to their potential to cause long-term sensory, motor, and functional impairments in patients. This study evaluates the major causes of anesthesia-related nerve injuries and examines effective remedial strategies essential for ensuring patient safety. The findings reveal that nerve injuries commonly arise from factors such as improper patient positioning, regional anesthesia techniques, prolonged surgical duration, anatomical variations, and the use of excessive mechanical pressure during procedures. Inadequate practitioner experience and insufficient preoperative assessments further heighten the risk. The study underscores the importance of early recognition and systematic evaluation to reduce the incidence and severity of such injuries. Remedial strategies identified include enhanced clinical training, adoption of ultrasound-guided regional anesthesia, and strict adherence to positioning protocols, improved monitoring systems, and timely postoperative neurological assessment. The study concludes that anesthesia nerve injuries remain a critical patient-safety concern, requiring continuous vigilance and evidence-based practice. Understanding their major causes ranging from patient factors to surgical positioning and anesthetic techniques is essential for effective prevention. One of the recommendations made was that comprehensive preoperative risk assessments should be implemented to identify patients with predisposing factors such as diabetes, obesity, neuropathies, or vascular diseases, ensuring customized preventive strategies are applied.
1. Ahmed, S. (2021). Perioperative Nerve Injuries: Mechanisms and Outcomes. Journal of Clinical Anesthesia, 18(3).
2. Anzaku, I., (2019). What is a Nerve?, Available at: https://byjus.com/biology/nerves/
3. Bais, K., Guirguis, F., & Guirguis, M. (2024). Nerve injury following regional nerve block: literature review. Current Pain and Headache Reports.
4. Barrington, M. (2019). Patient-related risk factors and prevention of peripheral nerve injury in anesthesia. Regional Anesthesia and Pain Medicine, 44(5), 567–575.
5. Bear, M. F., Connors, B. W., & Paradiso, M. A. (2020). Neuroscience: Exploring the Brain (4th ed.). Wolters Kluwer.
6. Brull, R., & Macfarlane, A. J. R. (2015). Pathophysiology and etiology of nerve injury following regional anesthesia. Regional Anesthesia and Pain Medicine.
7. Chang, A. (2023). Peripheral nerve blocks. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459210.
8. Chang, S., Kim, J., & Lee, H. (2021). Anesthetic complications related to nerve injury: Mechanisms and prevention. Journal of Anesthesia and Clinical Research, 45(2), 112–120.
9. Chen, X., & Li, Z. (2020). Mechanisms and classifications of peripheral nerve injuries. Neural Regeneration Research, 15(6), 1080–1088.
10. Cleveland Clinic. (2022). Peripheral nerves: Function & anatomy. Cleveland Clinic. https://my.clevelandclinic.org
11. Elsevier (2025). Nerve Injury. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/nerve-injury
12. Fernandes, A. (2024). Psychosocial Burden of Anesthesia-related Neurological Complications. Anesthesia & Analgesia.
13. Fiveable Content Team. (2025). Nerves definition. Fiveable. Retrieved from https://fiveable.me/key-terms/anatomy-physiology/nerve
14. Goldsmith, A. J., Edwards, J. T., & Hernandez, R. (2024). Complication rates of peripheral nerve blocks: A national analysis of ultrasonography-guided regional anesthesia outcomes. JAMA Network Open, 7(2), e235612. https://doi.org/10.1001/jamanetworkopen.2023.5612
15. González-Suárez, L. (2022). Motor Deficits from Anesthesia-related Nerve Trauma. International Journal of Surgery.
16. Hadzic, A., & Neal, J. (2024). Advances in regional anesthesia safety and nerve injury prevention. Regional Anesthesia Updates, 9(1), 33–47.
17. Hall, J. E., & Guyton, A. C. (2016). Guyton and Hall Textbook of Medical Physiology (13th ed.). Elsevier.
18. Hand surgeon (2023). Nerve Injury. https://assh.my.site.com/handcare/condition/nerve-injury
19. Harhaus, L. (2024). The treatment of peripheral nerve injuries: Current perspectives and future directions. Neural Regeneration Research, 19(3), 543–552. https://doi.org/10.4103/1673-5374.380043
20. Hewson, D. W. (2018). Peripheral nerve injury arising in anaesthesia practice. Association of Anaesthetists.
21. Hines, R., & Warner, M. (2020). Perioperative nerve injuries associated with anesthesia: Causes and prevention. Anesthesiology Research and Practice, 2020, 1–8.
22. Hogan, Q. H. (2008). Pathophysiology of peripheral nerve injury during regional anesthesia. Anesthesiology/related review.
23. Jeng, C. (2020). Peripheral nerve injury associated with anesthesia: Etiology and clinical implications. Anesthesia & Analgesia, 130(4), 1012–1020.
24. Kim, Y. D., Park, S., & Cho, J. (2021). Clinical manifestations and evaluation of nerve injury disorders. Journal of Neurological Science, 428, 117–124.
25. Kopp, S. (2020). Improving anesthetic safety through enhanced provider training and competency development. Journal of Clinical Anesthesia, 64 (3), 109–115.
26. Lee, H., & Park, J. (2020). Neuropathic Pain Following Regional Anesthesia: A Clinical Review. Pain Research & Management.
27. Malik, R. (2023). Loss of Sensation After Peripheral Nerve Injury: Clinical Implications. Journal of Perioperative Medicine.
28. Marieb, E. N., & Hoehn, K. (2018). Human Anatomy & Physiology (11th ed.). Pearson.
29. Mogensen, T., & Allen, P. (2021). Clinical outcomes and prognosis of anesthesia-related peripheral nerve injuries. Journal of Clinical Neurology, 17(4), 350–359.
30. Neal, J. (2021). Mechanisms and prevention of nerve injury during regional anesthesia. *British Journal of Anaesthesia, 126(3), 721–733.
31. Neal, J. M., Bernards, C. M., Hadzic, A., Hebl, J. R., Hogan, Q. H., Horlocker, T. T., Lee, L. A., Rathmell, J. P., & Eric, J. S (2018). ASRA practice advisory on neurologic complications in regional anesthesia. Regional Anesthesia and Pain Medicine
32. O’Connor, P., & Brull, R. (2022). Mechanisms of nerve injury in regional anesthesia. British Journal of Anaesthesia, 129(5), 678–689.
33. Patel, R., Singh, A., & Omar, S. (2023). Risk factors and prevention strategies for anesthesia-induced nerve complications. International Journal of Perioperative Medicine, 18(3), 210–219.
34. Provenzano, D. A., (2025). Updated clinical practice recommendations for preventing and managing nerve injury associated with regional anesthesia. Regional Anesthesia & Pain Medicine, 50(1), 12–25. https://doi.org/10.1136/rapm-2024-104652
35. Seidel, G. K., Morgan, C. R., & Wang, T. (2025). Electrodiagnostic assessment of peri-procedural nerve injury: Timing and prognostic value. Muscle & Nerve, 72(1), 44–57. https://doi.org/10.1002/mus.28114
36. Sites, B. (2018). Ultrasound guidance and the reduction of peripheral nerve injury in regional anesthesia. Current Opinion in Anaesthesiology, 31(5), 649–654.