Transfusion
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In 1994, 11 patients with injury to upper extremity cutaneous nerves after routine venipuncture were reported. All developed causalgia (Complex Regional Pain Syndrome, Type 2). Nerve injury appeared secondary to direct trauma via "inappropriate" needle or bolused material entry into the plane of the nerves beneath the veins, or nerves overlying the veins. However, in 3 of 13 additional patients, the venipunctures were properly performed and atraumatic. ⋯ Anatomical relationships between upper extremity superficial veins and cutaneous nerves are so intimate that needle-nerve contact during venipuncture is common. Because venipuncture-induced nerve injuries are rare, factors other than direct nerve contact appear necessary for the chronic pain syndrome to occur.