Forced Needle Advancement During Needle-Nerve Contact in a Porcine Model

Steinfeldt, Thorsten; Poeschl, Sabine; Nimphius, Wilhelm; J, Graf; Zoremba, Martin; Mueller, Hans-Helge; Wulf, Hinnerk; Dette, Frank

doi:10.1213/ane.0b013e31821b2227

Cited by 42 publications

(35 citation statements)

References 7 publications

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“…[1][2][3] Recently, high opening injection pressure (OIP) was reported to detect contact of the needle-tip with the nerve roots during brachial plexus blockade. 4,5 Opening injection pressure monitoring prevented the injection of local anesthetic against the epineurium of the interscalene brachial plexus in 97% of cases.…”

mentioning

confidence: 99%

High Opening Injection Pressure Is Associated With Needle-Nerve and Needle-Fascia Contact During Femoral Nerve Block

Gadsden

Latmore

Levine

et al. 2016

Regional Anesthesia and Pain Medicine

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mentioning

confidence: 99%

High Opening Injection Pressure Is Associated With Needle-Nerve and Needle-Fascia Contact During Femoral Nerve Block

Gadsden

Latmore

Levine

et al. 2016

Regional Anesthesia and Pain Medicine

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“…Apart from intraneural injections of local anaesthetics, we observed that the puncturing of nerves with larger needles (18G), as used for catheter techniques, could eventually result in fascicular damage and intraneural bleeding 25 . Additionally, we found even myelin injury due to needle advancement during needle nerve contact 26 . In conclusion, paraesthesia seems to specifically indicate either a needle nerve contact or intraneural needle tip position ---where both may lead to nerve injuries.…”

mentioning

confidence: 71%

Needle-nerve proximity during peripheral nerve blocks – Where is the right target and how can we get there?

Steinfeldt

Wiesmann

2015

Revista Española de Anestesiología y Reanimación

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“…The mechanisms accounting for nerve damage include fascicle trauma, ischaemia and local anaesthetic toxicity 9 . More recently needle-epineurium contact was associated with intraneural haematoma, inflammation and myelin damage in over half of cases in animal studies [10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Trainee anaesthetist diagnosis of intraneural injection—a study comparing B-mode ultrasound with the fusion of B-mode and elastography in the soft embalmed Thiel cadaver model

Munirama¹,

Zealley²,

Schwab³

et al. 2016

British Journal of Anaesthesia

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Citation for published version (APA):Munimara, S., Zeally, K., Schwab, A., Columb, M., Corner, G. A., Eisma, R., & McLeod, G. A. (2016). Trainee anaesthetist diagnosis of intraneural injection. A study comparing B-Mode ultrasound with the fusion of B-Mode and elastography in the soft embalmed Thiel cadaver model. British Journal of Anaesthesia, 117(6), 792-800. DOI: 10.1093/bja/aew337General rights Copyright and moral rights for the publications made accessible in Discovery Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from Discovery Research Portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain.• You may freely distribute the URL identifying the publication in the public portal. Take down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Running head Elastography diagnosis of intraneural injectionPage 2 of 26 British Journal of Anaesthesia 3 ABSTRACT Background: The incidence of intraneural injection during trainee anaesthetist ultrasound guided nerve block varies between 16% in experts and up to 35% in trainees. We hypothesised that elastography, an ultrasound-based technology that presents colour images of tissue strain had the potential to improve trainee diagnosis of intraneural injection during UGRA when integrated with BMode ultrasound onto a single image. Conclusions: Fusion elastography improved the accuracy, reliability and confidence of trainee anaesthetist diagnosis of intraneural injection. Methods

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Forced Needle Advancement During Needle-Nerve Contact in a Porcine Model

Abstract: The severity of structural nerve injury after needle-nerve contact was directly related to force exposure via needle advancement.

Cited by 42 publications

References 7 publications

High Opening Injection Pressure Is Associated With Needle-Nerve and Needle-Fascia Contact During Femoral Nerve Block

High Opening Injection Pressure Is Associated With Needle-Nerve and Needle-Fascia Contact During Femoral Nerve Block

Needle-nerve proximity during peripheral nerve blocks – Where is the right target and how can we get there?

Trainee anaesthetist diagnosis of intraneural injection—a study comparing B-mode ultrasound with the fusion of B-mode and elastography in the soft embalmed Thiel cadaver model

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