Sciatic nerve palsy following uneventful sciatic nerve block

We describe the loss of function in the sciatic nerve after an uneventful sciatic nerve block using 25 mi of lignocaine 1% with adrenaline 1 in 200 000 in a patient receiving beta blocker drugs. Lack of pain on injection and complete regeneration of the nerve after 12 months in a patient with severe peripheral vascular disease led us to postulate ischaemic nerve damage as a mechanism of injury. Adrenaline-induced unopposed alpha-mediated vasoconstriction in a beta-blocked patient is suggested as a possible mechanism of peripheral nerve injury worthy of further investigation.