“Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part C (Prevention of Nerve Injuries)

“A clever person solves the problem. A wise avoids it” (Albert Einstein). There is no convincing evidence that any modality 100% effectively prevents nerve injury. The risk of injury remains same even with ultrasound due to limitations in resolution images and inter-operator inter-patient differences. In a nutshell, caution required when dealing precious nerves perioperative period, either during peripheral blocks (PNBs), patient positioning, or surgery. Identifying pre-existing injury, trauma an existing neuropathy, preventing further should be important goal providing safe regional anesthesia (RA). Multimodal monitoring key avoiding multifactorial injuries. use triple guidance (ultrasound + stimulator injection pressure monitor) PNBs improves safety RA. helps real-time visualization nerve, needle, drug spread; confirm target nerves; monitor avoid Such multimodalities can also give confidence administer PNB without This article part comprehensive overview essential understanding before blocking them. It describes various preventive measures injuries while administering PNBs. will help readers understand importance prevention each step PNIs.