A 25 year old male with roadside accident underwent debridement and reduction of fractured both bones right forearm under axillary block. On the second postoperative day the patient complained of persistent numbness and paresthesia in the right forearm and the hand. The commonest cause of this neurological dysfunction could be all of the following except –
In local anesthetic toxicity there is circumoral (perioral) numbness and tongue paresthesia (not paresthesia & numbness in hand & fore arm).
This patient is having signs of peripheral nerve injury.
The involvement of the peripheral nerve is characterized by paresthesias, numbness, hypoesthesia, pain and neurological dysfunction.
So, this patient is having peripheral nerve injury. It could have happened d/t.


Open (crush) injury l/t laceration of nerves. As the patient underwent debriment so he is a case of open injury.
Nerve injury during debridement
Nerve injury during reduction & manipulation
Tourniquet pressure palsy
Nerve injury d/t tight bandage or cast
Crush injury to the hand and lacerated nerves
A tight cast or dressing
Systemic toxicity of local anaesthetics
Tourniquet pressure