Disclosure of risks associated with regional anesthesia: a survey of academic regional anesthesiologists.

BACKGROUND AND OBJECTIVES

In view of the relatively few large studies available to estimate the rates of complications following regional anesthesia, we aimed to identify and quantify the risks that academic regional anesthesiologists and regional anesthesia fellows disclose to their patients before performing central and peripheral nerve blockade.

METHODS

We asked 23 North American regional anesthesia fellowship program directors to distribute a questionnaire to the regional anesthesiologists and regional anesthesia fellows at their institutions. The questionnaire was designed to capture the risks and corresponding incidences that are routinely disclosed to patients before performing the most common central and peripheral nerve block techniques.

RESULTS

The total number of respondents was 79 from 12 different institutions. Fifty-eight (74%) respondents disclose risks of regional anesthesia in order to allow their patients to make an informed choice, whereas 20 (26%) disclose risks for medicolegal reasons. For central neural blockade, the most commonly disclosed risks are headache, local pain/discomfort, and infection. For peripheral nerve blockade, the most commonly disclosed risks are transient neuropathy, local pain/discomfort, and infection. For both central and peripheral nerve blockade, the risks most commonly disclosed are also those with the highest-reported incidences.

CONCLUSIONS

The risks of regional anesthesia most commonly disclosed to patients by academic regional anesthesiologists and regional anesthesia fellows are benign in nature and occur frequently. Severe complications of regional anesthesia are far less commonly disclosed. The incidences of severe complications disclosed by academic regional anesthesiologists and their fellows can be inconsistent with those cited in the contemporary literature.