Effect of Impulse Duration on Patients' Perception of Electrical Stimulation and Block Effectiveness During Axillary Block in Unsedated Ambulatory Patients

Comfort and satisfaction during axillary brachial plexus block in trauma patients: comparison of techniques

“…In keeping with other studies [6][7][8] that compared electrical stimulation with repeated needle passes and local anesthetic injection, we found that electrical impulse was the most unpleasant component of the anesthetic procedure. Koscielniak-Nielsen et al [7] reported the effect of impulse duration on patients' perception of electrical stimulation. Twenty-eight patients (64%) in short impulse duration and 22 (52%) in long impulse duration experienced pain, with a median VAS (0-100) of 21 and 24, respectively.…”

“…Several studies have assessed global pain caused by multiple electrolocation [3,8,15]. In keeping with other studies [6][7][8] that compared electrical stimulation with repeated needle passes and local anesthetic injection, we found that electrical impulse was the most unpleasant component of the anesthetic procedure. Koscielniak-Nielsen et al [7] reported the effect of impulse duration on patients' perception of electrical stimulation.…”

“…Twenty-eight patients (64%) in short impulse duration and 22 (52%) in long impulse duration experienced pain, with a median VAS (0-100) of 21 and 24, respectively. In our report, discomfort during the block, as measured by VAS (0-10), was a mean of 4.5, which is higher than results of the literature [2,7,16]. Casati et al [16] reported a median degree of anesthesia-related pain measured by VAS (0-10) during axillary brachial plexus block and electrical nerve stimulation of 3.…”

“…Electrical stimulation for needle localization may cause patient discomfort during axillary brachial plexus block and consequent dissatisfaction [2][3][4][5]. Some studies [6][7][8] have identified electrical stimulation as the main cause of this discomfort, when compared with repeated needle passes and anesthetic local injections. This finding is particularly important for patients with trauma of the hand or forearm, where electrically stimulated muscle contractions and needle movement may increase both patient discomfort and pain.…”

Plexus brachialis

“…Der Stimulationserfolg ist abhängig von der Stromstärke (mA) und der Impulsbreite (ms) bei einer Stimulationsfrequenz von gewöhnlich 1-2 Hz. Zur Stimulation motorischer Nerven (Aα-Fasern) wird eine Impulsbreite von 0,1 ms,zur Stimulation sensorischer Fasern eine Impulsbreite von 0,3 ms (kleinere myelinisierte Fasern) bis 1,0 ms (C-Fasern) verwendet [30].Wird die Impulsbreite von 0,1 ms nicht überschritten, ist eine nahezu schmerzfreie selektive motorische Stimulation möglich [52].Das Gefühl der unwillkürlichen Muskelaktivität allein kann jedoch für den Patienten unangenehm sein. Deshalb sollte er darüber informiert werden.…”