1. General Considerations
    1. Please use existing complication categories and avoid using “other” (e.g. a catheter disconnect should be a “catheter problem”, not “other… catheter disconnect”) and reclassify complications during the audit process if necessary.
    2. Please do not hesitate to use free text and comments. These are very valuable for data analysis. Any complications or subtypes listed as “other” require comment.
    3. Please ensure that follow-up questions are completed for all complications: severity grading/outcome, interventions needed (e.g., remove catheter, administer antibiotics, consults), location, number of days to complication, length of hospitalization increase.
  2. Definitions
    1. Intraoperative
    2. positive test dose – > 10% increase in HR or SBP or 25% increase in T-wave amplitude, patient-reported symptoms (tinnitus, circumoral numbness, metallic taste)
    3. inadvertent dural puncture – CSF aspirate (or free-flow via needle or catheter)
    4. inadvertent vascular puncture -blood aspirated in syringe (or free-flow via needle or catheter)
    5. abandoned block – unable to place block or thread catheter; block aborted for any reason
    6. failed block – technically successful (completed) block but not clinically successful based on clinical assessment, e.g., alteration in anticipated anesthetic needs
    7. respiratory – hemo/pneumothorax, diaphragmatic paralysis causing respiratory insufficiency, apnea, other
    8. cardiovascular – arrhythmia, cardiac arrest, other
    9. neurologic – altered mental status, seizure, other
    10. other – only a complication that cannot be placed into any of the above categories; details should be specified in database free text box
    11. Postoperative
    12. failed block – technically successful block but not successful based on clinical assessment, e.g., lack of analgesia or evidence of blockade in recovery area
    13. unintentional unilateral block – applies to neuraxial techniques; regardless of whether the side blocked is operative or nonoperative
    14. prolonged block – greater than anticipated duration for single-injection or after catheter is removed
    15. excessive motor blockade – physician judgment based on local anesthetic dosing and clinical situation (e.g., cannot complete physical therapy, delayed ambulation)
    16. catheter problem – any catheter issue that precludes delivery of planned regional infusion (e.g., occluded, kinked, accidental dislodgement, disconnected at hub/infusion pump, fractured or retained catheter), other
    17. adverse drug reaction – local anesthetic toxicity, anaphylaxis
    18. respiratory – respiratory depression, apnea, diaphragmatic paralysis causing respiratory insufficiency, other
    19. neurologic – seizure, paresthesia/dysesthesia, paralysis, post-dural puncture headache, altered mental status, Horner syndrome, other
    20. hematoma – epidural or peripheral
    21. infection – insertion site (erythema, cellulitis), deep (abscess, meningitis)
    22. other – only a complication that cannot be placed into any of the above categories; details should be specified in database free text box