Nerve injury by needle nerve perforation in regional anaesthesia: does size matter?

Steinfeldt, Thorsten; Nimphius, Wilhelm; Werner, Tilmann; Vassiliou, T.; Kill, Clemens; Karakas, Elias; Wulf, Hinnerk; Graf, Jürgen

doi:10.1093/bja/aep366

Cited by 53 publications

(36 citation statements)

References 26 publications

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“…67 Increased needle diameter worsens the severity of nerve injury after needle-nerve perforation. 68 In the setting of neuraxial anesthesia, the dural lesions produced by different needle types vary in morphology and characteristics; a Whitacre needle produces a more traumatic opening with tearing and severe disruption of the collagen fibers compared with a Quincke needle that resulted in a clean-cut opening. 69 …”

Section: Needle Typementioning

confidence: 99%

Pathophysiology and Etiology of Nerve Injury Following Peripheral Nerve Blockade

Brull

Hadžić

Reina

et al. 2015

Regional Anesthesia and Pain Medicine

184

106

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Section: Needle Typementioning

confidence: 99%

Pathophysiology and Etiology of Nerve Injury Following Peripheral Nerve Blockade

Brull

Hadžić

Reina

et al. 2015

Regional Anesthesia and Pain Medicine

184

106

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“…Selander et al [89] konnten 1977 zeigen, dass der Nervenschaden bei Benutzung scharf geschliffener Nadeln ausgeprägter ist. Neuere Untersuchungen sind z. T. widersprüch-lich und weisen darauf hin, dass sowohl die Konfiguration der Nadelspitze als auch der Durchmesser der Kanüle einen Einfluss auf das Ausmaß des Nervenschaden haben können [61,93,94]. Je größer der Durchmesser einer Kanüle ist, umso grö-ßer ist (erwartungsgemäß) der aus einer intraneuralen (subepineuralen) Injektion resultierende Schaden.…”

Section: Nadelmaterialsunclassified

Komplikationen bei peripherer Regionalanästhesie

Neuburger

Büttner

2011

Anaesthesist

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Peripheral regional anesthesia is a commonly used and safe procedure and eneral complications or side effects are generally rare. Nerve damage has an incidence <0.1% depending on the definition and the prognosis is good. To avoid bleeding complications the national standards of block performance under antithrombotic therapy should be respected. Intoxication is mainly the result of accidental intravenous administration and is difficult to treat but higher doses of intravenous lipid emulsions can improve the outcome. Potential infectious complications can occur mainly as a result of catheter techniques and require a strict aseptic approach. Further rare complications are allergies, dislocation of catheters and knotting or loops in catheters. Besides the general complications, there are some specific complications depending on the puncture site, such as pneumothorax or renal puncture.

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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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Nerve injury by needle nerve perforation in regional anaesthesia: does size matter?

Cited by 53 publications

References 26 publications

Pathophysiology and Etiology of Nerve Injury Following Peripheral Nerve Blockade

Pathophysiology and Etiology of Nerve Injury Following Peripheral Nerve Blockade

Komplikationen bei peripherer Regionalanästhesie

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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