Regional anesthesia in surgery. Analysis of post-puncture complications: a review

This study aims to structure knowledge on the problem of regional anesthesia complications: its etiopathogenesis, symptoms, diagnostic methods, and approaches to prevention are examined.

Regional anesthesia is a crucial component of modern perioperative protocols, providing effective analgesia, reducing opioid use, and accelerating recovery. However, this technique is associated with certain risks, ranging from mild and temporary to severe and persistent complications. Their occurrence is often associated with noncompliance with clinical guidelines and standards. The most common early complications include block failure, toxic effects of local anesthetics on the central nervous and cardiovascular systems, and unintentional puncture of adjacent structures. Total spinal anesthesia with epidural technique poses a serious but rare risk.

Among neurological complications, transient neuropathies predominate, usually associated with surgical trauma, tension, or ischemia. Post-dural puncture headache after spinal anesthesia is a separate category. Infections (abscess, meningitis) and hematomas in the spinal canal are rare but carry the risk of irreversible spinal cord damage. The risk of complications is increased by technical difficulties, anatomical abnormalities, coagulopathy, and the patient's comorbidities.

Strict aseptic technique, the use of instrumental guidance for precision, and controlled dosage of local anesthetics play a key role in prevention.