2. Complications of blocks and/or analgesic techniques.
| Study | Complications related to regional anaesthesia | Complications related to analgesic technique |
| Albrecht 2014 | Not reported | Not reported |
| Altermatt 2013 | Not reported | Not reported |
| Antonopoulou 2006 | No complications such as motor block. local haematoma or infection, inadvertent arterial puncture, direct nerve damage, and cardiovascular or neurological toxicity were observed Five participants had accidental removal of the catheter: 4 during the procedure or while the catheter was secured, and 1 while in the ward |
Not reported |
| Bang 2016 | No patient developed any residual sensory‐motor deficit during the postoperative period | Patients in the non‐block group had nausea (N=2) and pruritus (N=1), and 1 patient in the block group had nausea within the first 2 postoperative days |
| Brownbridge 2018 | Not reported | Respiratory complications in 5 out of 15 participants for each group Opioid side effects after enrolment: 3/15 in the block group; 7/15 in the non‐block group |
| Chudinov 1999 | No major complications in group regional blockade were described. Three participants developed local erythema at the catheter insertion site at the end of the study period No signs of local anaesthetic toxicity were documented One participant developed bilateral blockade (L1‐L3 on the opposite side) |
Not reported |
| Coad 1991 | No complications related to nerve blocks and no case of prolonged motor blockade | Not reported |
| Cuvillon 2007 | Four catheters were prematurely removed: 1 by a confused participant, 2 by nurses (unexplained fever), and 1 by a surgeon (unconfirmed suspicion of local anaesthetic toxicity) (ropivacaine blood level < 2 ng/mL)) | More constipation (47% vs 19% for regional blockade) |
| De La Tabla 2010 | Not reported | Not reported |
| Deniz 2014 | Hypotension occurred in 1 participant in the fascia iliaca compartment block group (1/20) and in 1 participant in the femoral nerve block group (1/20) There was no complication that might be relevant to fascia iliaca compartment block in our study In 1 case, prolonged (4 months) temporary motor and sensory neurological deficits occurred due to 3‐in‐1 block |
Hypotension occurred in 2 patients with IV patient‐controlled analgesia (2/20), requiring stopping of IV patient‐controlled analgesia |
| Diakomi 2014 | Complications such as local anaesthetic toxicity recorded as well (none reported in results section) Nor did complication rates vary between groups |
Complications such as hypoventilation (breathing rate < 8 breaths/min) were recorded as well Moreover, the 2 groups did not differ in these parameters at any time point until study completion at 24 hours after surgery. Nor did complication rates vary between groups |
| Domac 2015 | Not reported | Not reported |
| Fletcher 2003 | Among study participants, none experienced adverse effects as a result of nerve block administration | No clinically important differences between groups with respect to pulse rate, oxygen saturation, or respiratory rate at any time interval. Oxygen saturation 94.87% |
| Foss 2005a | No side effects attributable to femoral nerve block were noted in any participants during their hospital stay | More participants (P = 0.05) in the morphine group were sedated at 180 minutes after block placement No difference in nausea and vomiting was noted between groups, with 3 participants in each group having these side effects Tendency towards lower saturation was noted in the opioid group at 60 and 180 minutes after the block despite oxygen supplementation (P = 0.08) |
| Gille 2006 | One inadvertent arterial puncture and blood aspiration positive for 3 participants Two transient paraesthesias No catheter site infection Ten catheters accidentally removed No severe complications related to analgesia |
No respiratory depression from systemic analgesia and no allergic reactions All complications were reversible |
| Godoy Monzon 2010 | The only complications were local bruises at the site of injection | Two participants with nausea and 2 with nausea and vomiting |
| Graham 2008 | No immediate complications occurred in either group defined as inadvertent vascular puncture, anaphylaxis or collapse, severe pain, or inability to tolerate the procedure | No immediate complications were noted in either group |
| Haddad 1995 | No local or systemic complications of femoral nerve blocks were noted | Not reported |
| Henderson 2008 | No complications associated with femoral nerve block were noted | Not reported |
| Hogg 2009 | One patient was withdrawn from the fascia iliaca compartment block group due to new‐onset arrhythmia | Not reported |
| Hood 1991 | No untoward sequelae were associated with nerve blocks All plasma prilocaine concentrations (maximum 3 pg/mL) were below the suggested threshold for toxicity for prilocaine of 6 pg/mL |
Not reported |
| Jadon 2014 | Not reported | In participants of fentanyl group, drowsiness was observed that required the presence of more persons holding the participant during positioning SpO2 was significantly lower in the fentanyl group (P = 0.001). However, no participant in either group had SpO2 < 90% during the procedure Mean arterial blood pressure was significantly lower in the fentanyl group (P = 0.0019) |
| Jang 2018 | All femoral nerve block procedures required a single attempt and no complications were observed | Nausea and vomiting 4 vs 6, hypotension 2 vs 4, pruritus 0 vs 1, and desaturation 3 vs 2 for intervention and comparator, respectively |
| Jones 1985 | No untoward sequelae associated with the nerve block were seen | Not reported |
| Kullenberg 2004 | No complications related to the nerve blockade were noted in this study | Not reported |
| Landsting 2008 | No serious adverse events due to the fascia iliaca compartment block were reported in this study | Not reported |
| Liebmann 2012 | No other adverse events were noted during the study period, and no other adverse events were reported to study investigators | Four‐hour oxygen saturation (%) 96 (93 to 99) vs (%) 98 (95 to 99) for regional blockade Adverse events: Hypotension, number (%) 3 (17) vs number (%) 0 (0) for regional blockade Respiratory depression, number (%) 9 (50) vs number (%) 4 (22) for regional blockade Nausea/vomiting, number (%) 5 (28) vs number (%) 5 (28) for regional blockade One participant had an episode of rapid atrial fibrillation requiring diltiazem, but the participant had a history of chronic atrial fibrillation |
| Luger 2012 | Not reported | Not reported |
| Ma 2018a | Two patients’ catheters kinked. This problem was solved after the catheter was adjusted No other complications (local anaesthetic toxicity, puncture site infection, haematoma, catheter dislodgment) occurred |
The occurrence of nausea and vomiting in group fascia iliaca compartment block were lower than those in group control. No patients experienced respiratory depression and over‐sedation in 2 groups during the waiting period |
| Madabushi 2016 | No complications were noted in either group | No complications were noted in either group |
| Morrison 2008 | There were no episodes of bleeding, falls, or catheter‐related infections in the intervention group | Intervention participants were significantly less likely to report opioid side effects |
| Mosaffa 2005 | Not reported | Not reported |
| Mouzopoulos 2009 | No complications of femoral nerve block administration occurred, except 3 local haematomas developed at the injection site, which resolved spontaneously | Not reported |
| Murgue 2006 | Not reported | Not reported |
| Nie 2015 | No adverse effects such as pain at the insertion site or paraesthesia were observed No positive cultures were observed with the fascia iliaca block catheter tip, nor were any signs of infection noted in the current study |
Not reported |
| Ranjit 2016 | There was no inadvertent vascular puncture nor adverse effect of systemic local anaesthetic toxicity in the study group | SpO₂ was significantly lower in the IV fentanyl group during positioning (95 vs 97; P < 0.001) and 5 minutes after (95 vs 98; P < 0.001). However, none of the patients in either group had their oxygen saturation below 90% |
| Segado Jimenez 2009 | We did not observe any complications in the realization of regional anaesthetic techniques during or subsequent to these techniques | The incidence of side effects (sleepiness, hypotension, constipation, pruritus) was greater in the group with no block than in groups with blocks (P < 0.01) |
| Spansberg 1996 | No haematomas at the site of femoral catheters | Two participants in each group experienced nausea and vomiting |
| Szucs 2010 | For 1 participant, the elastomeric pump failed, resulting in local anaesthetic administered over less than 54 hours instead of 72 hours, and another participant, suffering from acute confusional state, disconnected his pump after 12 hours | The incidence of nausea/vomiting, pruritus, or excessive sedation was similar in the 2 groups |
| Thompson 2019 | Of the 23 patients in group fascia iliaca compartment block, there were no intervention‐related complications or adverse events. None of the patients receiving a block reported residual injection site pain, sensory or motor deficits, intravascular injections, cardiopulmonary events, or other adverse events | Not reported |
| Tuncer 2003 | Not reported | Side effects (vomiting and pruritus) were observed significantly more frequently with intravenous analgesia |
| Unneby 2017 | No adverse events related to the femoral nerve block were noted | Not reported |
| Uysal 2018 | Not reported | Not reported |
| Wang 2015 | The study group did not develop complications (local anaesthetic toxicity, puncture site infection, hematoma in preoperative waiting period) | All patients in the present study did not demonstrate symptoms of respiratory depression and excessive sedation in the preoperative waiting period Nausea 7 vs 12 and vomiting 5 vs 5 for intervention and comparator, respectively |
| White 1980 | No participants showed any evidence of local anaesthetic toxicity | Not reported |
| Yamamoto 2016 | Patients were also evaluated for potential drug‐ or block‐related complications during the course of the trial No complications |
Patients were also evaluated for potential drug‐ or block‐related complications during the course of the trial No complications |
| Yang 2016 | Not reported | Fewer side effects for fascia iliaca compartment block group Nausea and vomiting 0 vs 3, respiratory depression 0 vs 1 for intervention and comparator, respectively |
| Yun 2009 | No adverse systemic toxicity of ropivacaine was noted, and neither vascular puncture nor paraesthesia was elicited No complications such as haematoma or persistent paraesthesia were observed in participants with a femoral nerve block within 24 hours after the operation |
Hypoventilation (ventilatory rate 6 to 8/min) or pulse oximetric desaturation (oxygen saturation 88% or 89%) was encountered in 4 participants (20%) in the intravenous analgesia group. This was reverted with assisted manual mask ventilation All participants in the intravenous group experienced mild dizziness, and mild drowsiness was present in 12/20 of them |
Brief summary: For peripheral nerve block, there was no case of systemic local anaesthetic toxicity and no infection. One case of prolonged (4 months) temporary motor and sensory neurological deficit occurred due to a 3‐in‐1 block (Deniz 2014). One new‐onset arrhythmia was reported (Hogg 2009). Four cases of respiratory depression requiring face mask ventilation were reported with intravenous analgesia (Yun 2009). Other opioid side effects such as drowsiness, hypoventilation, desaturation, hypotension, nausea and vomiting, pruritus, and constipation were reported in both groups. No allergic reaction was reported.
%: percentage.
L: litre.
mg: milligram.
min: minute.
ng/mL: nanogram/millilitre.
pg/mL: picogram/millilitre.