Axillary Block Complicated by Hematoma and Radial Nerve Injury

Background and Objectives. Hematoma is typically cited as one mechanism of nerve injury following axillary block. However, documented cases of this are lacking. Methods. 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. Post-operative, the patient developed a large axillary hematoma accompanied by paresthesias and radial nerve weakness. Results. With conservative management, nerve recovery was complete in 6 months. Conclusions. Hematoma complicating axillary block may result in nerve dysfunction.