Local and regional anaesthesia: pain on injection during a nerve block: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Local and regional anaesthesia: pain on injection during a nerve block

Sample item

During an ultrasound-guided sciatic nerve block, the patient reports severe lancinating pain as injection begins, and the injection pressure is high. What is the correct action?

AIncrease the concentration of the local anaestheticBAdd steroid to reduce the painCComplete the injection rapidly, since the pain will passDStop injecting and reposition the needle

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Stop injecting and reposition the needle

Severe pain, paraesthesia or high injection pressure suggests intraneural or intrafascicular placement, which risks permanent nerve injury. The injection is stopped and the needle withdrawn and repositioned until the injection is easy and painless.

Option by option

A. Increase the concentration of the local anaesthetic
A stronger solution increases the toxicity and does not solve the problem.
B. Add steroid to reduce the pain
Steroids do not make an intraneural injection safe.
C. Complete the injection rapidly, since the pain will pass
Finishing the injection would deliver drug into the nerve.
D. Stop injecting and reposition the needle (correct)
Correct. Stopping prevents injury from an intraneural injection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Stop injecting and reposition the needle. Severe pain, paraesthesia or high injection pressure suggests intraneural or intrafascicular placement, which risks permanent nerve injury.

Why is "Increase the concentration of the local anaesthetic" not the answer?

A stronger solution increases the toxicity and does not solve the problem.

Why is "Add steroid to reduce the pain" not the answer?

Steroids do not make an intraneural injection safe.

Why is "Complete the injection rapidly, since the pain will pass" not the answer?

Finishing the injection would deliver drug into the nerve.

What concept does this question test?

It tests Local and regional anaesthesia: pain on injection during a nerve block in Anaesthesia. The injection is stopped and the needle withdrawn and repositioned until the injection is easy and painless.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Local and regional anaesthesia: pain on injection during a nerve block?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.