Venipuncture-Related Lateral Antebrachial Cutaneous Nerve Injury in Primary Care Settings

Published:January 12, 2022DOI:https://doi.org/10.1016/j.nurpra.2021.12.004

      Highlights

      • Nerve injury during antecubital venipuncture is rare.
      • Injury during antecubital venipuncture may cause paresthesia of the forearm related to lateral antebrachial cutaneous nerve injury.
      • Most of the neuropathic pain following venipuncture nerve injury resolves within 1 week to 6 months.

      Abstract

      Given the close proximity of nerves to veins commonly accessed for phlebotomy, venipuncture at the antecubital fossa has resulted in nerve injury, including damage to the lateral antebrachial cutaneous nerve. Although rare, direct needle trauma can cause paresthesia, radiating arm pain, and weakness of the hand or forearm. This case report describes a healthy female who experienced 3 weeks of venipuncture-related paresthesia and pain after an atraumatic venipuncture in the primary care setting.

      Keywords

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to The Journal for Nurse Practitioners
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Thompson J.
        Regional anesthesia: upper and lower extremity blocks.
        in: Nagelhout J. Sass E. Nurse Anesthesia. 6th ed. Elsevier, 2018: 1042-1063
        • Newman B.H.
        • Waxman D.A.
        Blood donation-related neurologic needle injury: evaluation of 2 years’ worth of data from a large blood center.
        Transfusion. 1996; 36: 213-215https://doi.org/10.1046/j.1537-2995.1996.36396182137.x
        • Stevens R.J.
        • Mahadevan V.
        • Moss A.L.
        Injury to the lateral cutaneous nerve of forearm after venous cannulation: a case report and literature review.
        Clin Anat. 2012; 25: 659-662https://doi.org/10.1002/ca.21285
        • Horowitz S.H.
        Peripheral nerve injury and causalgia secondary to routine venipuncture.
        Neurology. 1994; 44: 962-964https://doi.org/10.1212/wnl.44.5.962
        • Ramos J.A.
        Venipuncture-related lateral antebrachial cutaneous nerve injury: what to know?.
        Braz J Anesthesiol. 2014; 64: 131-133https://doi.org/10.1016/j.bjane.2013.06.003
        • Kagel E.M.
        • Rayan G.M.
        Intravenous catheter complications in the hand and forearm.
        J Trauma. 2004; 56: 123-127https://doi.org/10.1097/01.TA.0000058126.72962.74
        • Berry P.R.
        • Wallis W.E.
        Venipuncture nerve injuries.
        Lancet. 1977; 1: 1236-1237https://doi.org/10.1016/s0140-6736(77)92442-4
        • Kato J.
        • Araki H.
        • Kimura M.
        • et al.
        Incidence and prognosis of persistent pain induced by venipuncture for blood sampling: an observational study over a 5-year period.
        Pain Med. 2012; 13: 1627-1630https://doi.org/10.1111/j.1526-4637.2012.01490.x
        • Watts D.
        • Kremer M.J.
        Complex regional pain syndrome: a review of diagnostics, pathophysiologic mechanisms, and treatment implications for certified registered nurse anesthetists.
        AANA J. 2011; 79: 505-510
        • O’Connor A.B.
        • Dworkin R.H.
        Treatment of neuropathic pain: an overview of recent guidelines.
        Am J Med. 2009; 122: S22-S32https://doi.org/10.1016/j.amjmed.2009.04.007
        • Shields L.B.E.
        • Sutton B.
        • Iyer V.G.
        • Shields C.B.
        • Rao A.J.
        Venipuncture-related median nerve palsy disguised as intraoperative brachial plexus injury.
        Case Rep Neurol. 2021; 13: 361-368https://doi.org/10.1159/000515474

      Biography

      Jessica Szydlowski Pitman, DNP, CRNA, ACNP, is an assistant clinical professor, Duke University School of Nursing, Durham, NC, and can be contacted at [email protected] .

      Biography

      Emily M. Funk, DNP, CRNA, is an assistant clinical professor at Duke University School of Nursing, Durham, NC.

      Biography

      Christian Falyar, DNAP, CRNA, is an assistant clinical professor at Duke University School of Nursing, Durham, NC.