TABLE 11Nerve damage associated with venepuncture

StudySubjectPurpose and site of venepunctureDiagnosisOutcomeComment
Berry and Wallis 19772450-year-old womanBlood grouping; left antecubital fossaInjury to the medial cutaneous nervePain and swelling in the forearm developed within 24 hours into hyperaesthesia in the whole forearm. A striking improvement was noted 24 hours after treatment with carbamazepine and 3 days later the only symptom was slight pain on moving the arm. Treatment was discontinued after 5 weeks, when the patient had no symptoms except slightly impaired touch sensation in the sensory distribution of the left medial cutaneous nerve20-gauge needle used
Horowitz 19941761-year-old womanBlood sampling; antecubital fossaCausalgia affecting medial antebrachial cutaneous nerveIncreased symptoms and motor abnormalities of disuse, with joint contracture and psychiatric depression requiring antidepressant medication, observed at 7 years
Horowitz 19941761-year-old manBlood sampling; antecubital fossaCausalgia affecting lateral antebrachial cutaneous nerveIncreased symptoms and motor abnormalities of disuse, with joint contracture and psychiatric depression requiring antidepressant medication, observed at 4 years
Horowitz 19941756-year-old womanBlood sampling; antecubital fossaCausalgia affecting medial antebrachial cutaneous nerveIncreased symptoms, with joint contracture and motor abnormalities of disuse, observed at 18 months
Horowitz 19941735-year-old manBlood sampling; wristCausalgia affecting superficial radial nerveThe burning pain resolved spontaneously over a 2-week period, but hyperpathia and allodynia in the injured nerve distribution persisted at 2.5 years
Nouri et al. 20002059-year-old womanRoutine phlebotomy for pre-operative assessment; radial veinCausalgia affecting radial nerveImmediate acute pain and numbness; dysaesthesia, hyperaesthesia, allodynia and loss of muscular power still persisted a year later. Following treatment with paroxetine, tramadol and capsaicin (Zacin®, Cephalon) and six nerve blocks, the pain in the arm and forearm was almost completely resolved, and that in the hand and wrist was somewhat reduced20-gauge needle used. Venepuncture said to be difficult, requiring three attempts
Pradhan and Gupta 19952132-year-old woman with a minor pyrexial illnessRoutine blood testing; cubital veinMedian nerveImmediate intense pain in whole of left arm persisting on the palmar aspect of the forearm and hand, and accompanied by weakness and tingling. The paraesthesia subsided in 2 months; mild anaesthesia in radial side of palm persisted for 4 months; muscle power returned to normal with physiotherapy, but minimal wasting was still observed after 1 yearVenepuncture said to be very difficult because of non-visibility of veins
Saeed and Gatens 1983447-year-old manPre-operative phlebotomy; cubital veinAnterior interosseous syndromePain in forearm and inability to flex thumb noted 4 days after surgery. Surgical tendon transfer required 14 months later to enable appropriate movement of the thumbVenepuncture said to have been very difficult
Sander et al. 19982264-year-old womanPhlebotomy (purpose not stated); antecubitalLateral antebrachial cutaneous neuropathyAcute pain on insertion of needle followed by pain and numbness persisting, with some improvement, for 5 months
Yuan and Cohen 19852531-year-old manRoutine phlebotomy for pre-operative blood tests; cubital veinLaceration of the lateral antebrachial cutaneous nerve with neuroma formationExcruciating pain followed by numbness noted during venepuncture, followed by pain and numbness in the forearm persisting for 3 weeks, and resistant to treatment with butazolidin; lidocaine and steroid injection did not produce lasting relief. Surgery was performed on two occasions: the first was ineffective; the second relieved the pain but left permanent numbness. However, motor function was unimpairedRepeated attempts at venepuncture were required
Zubairy 20022344-year-old womanRoutine post-operative blood sampling; cubital fossaSevere anterior interosseus nerve lesionLoss of function in the thumb and index finger; weakness of pronation. Management was conservative. The first sign of spontaneous recovery was observed at 20 months and normal function at 34 months after the injury

From: 2, Clinical effectiveness

Cover of What is the Value of Routinely Testing Full Blood Count, Electrolytes and Urea, and Pulmonary Function Tests Before Elective Surgery in Patients with No Apparent Clinical Indication and in Subgroups of Patients with Common Comorbidities: A Systematic Review of the Clinical and Cost-Effective Literature
What is the Value of Routinely Testing Full Blood Count, Electrolytes and Urea, and Pulmonary Function Tests Before Elective Surgery in Patients with No Apparent Clinical Indication and in Subgroups of Patients with Common Comorbidities: A Systematic Review of the Clinical and Cost-Effective Literature.
Health Technology Assessment, No. 16.50.
Czoski-Murray C, Jones ML, McCabe C, et al.
Southampton (UK): NIHR Journals Library; 2012 Dec.
© 2012, Crown Copyright.

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