Axillary block complicated by hematoma and radial nerve injury.

Abstract

Hematoma is typically cited as one mechanism of nerve injury following axillary block. However, documented cases of this are lacking. A healthy 38-year-old man was scheduled for surgical removal of a tumor of the hand. A transarterial axillary block was performed with a 22-gauge short-bevel needle using 40 mL of a mixture of equal volumes of 1.5% lidocaine and 0.5% bupivacaine containing 1:200,000 epinephrine. No paresthesias were reported. Postoperative, the patient developed a large axillary hematoma accompanied by paresthesias and radial nerve weakness. With conservative management, nerve recovery was complete in 6 months. Hematoma complicating axillary block may result in nerve dysfunction.