Percutaneous Electrode Guidance Using the Insulated Needle for Prelocation of Peripheral Nerves During Axillary Plexus Blocks

Capdevila, Xavier; Lopez, Sandrine; Bernard, Nathalie; Dadure, Christophe; Motais, Frédéric; Biboulet, Philippe; Choquet, Olivier

doi:10.1097/00115550-200405000-00005

Cited by 11 publications

(3 citation statements)

References 21 publications

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“…28,29 The success rate of block performed following PEG using an insulated needle was reported as >85% by Capdevila et al. 9 This is similar to the block success rate of 80% using the pen device in the present study.…”

Section: Discussionsupporting

confidence: 89%

“…The use of modified electrocardiography electrodes or isolated needles has been shown to decrease the needle exploration time and needle passage count and to reduce procedure-related pain. 28,29 The success rate of block performed following PEG using an insulated needle was reported as >85% by Capdevila et al 9 This is similar to the block success rate of 80% using the pen device in the present study.…”

Section: Discussionsupporting

confidence: 87%

“…2,7,8 However, ultrasonography is not always available in operating rooms. 9 The use of peripheral nerve stimulation for nerve localization was first reported in the 1950s. 10,11 This method is invasive and may require multiple needle passages in order to obtain the desired motor or sensory response to electrical stimulation.…”

Section: Discussionmentioning

confidence: 99%

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Effect of nerve localization using a pen device on the success of axillary brachial plexus block

et al. 2014

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Objective: The effectiveness of axillary brachial plexus block (ABPB) performed using peripheral nerve stimulation (PNS) alone was compared with PNS preceded by nerve localization using a pen device, enabling nerve mapping without puncturing the skin. Methods: Patients undergoing unilateral hand or forearm surgery suitable for ABPB were randomly assigned to receive either PNS alone (pen À group) or PNS preceded by nerve localization using a pen device (pen þ group). Parameters related to the block procedure and patient comfort were assessed. Results: Thirty patients were included in each group. The block performance time was longer in the pen þ group than the pen À group despite a reduced number of needle insertions. The complete block rate was higher and intraoperative analgesic usage lower in the pen þ group compared with the pen À group. Patient satisfaction and complication rates were similar in the two groups. Conclusion: The pen device seems to be a helpful addition to PNS for ABPB, with improved results in terms of block success and patient comfort, but further studies are needed to confirm these findings.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

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Effect of nerve localization using a pen device on the success of axillary brachial plexus block

et al. 2014

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“Triceps Brachii Muscle Response to Neurostimulation of the Radial Nerve during Axillary Plexus Blockade: Clinical, Anatomical and Histological Correlation”

et al. 2019

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Axillary plexus blockade is a common technique in clinical practice with a well-known pattern of structures around the brachial artery. Historically, the only proper response to radial nerve stimulation was considered to be extension of the hand and wrist. Twenty-five axillary blockades were assessed by ultrasound and neurostimulation; the principal objective was to correlate the needle position over the radial nerve with the anatomical and histological structure of that nerve. During the procedure, the needle was directed in two ways to reach the medial or lateral margin of the nerve: above the brachial artery or beneath it. Once the needle reached the nerve, the current was augmented gradually until a response was elicited. For the cadaveric anatomical study, eight axillae were dissected and histological samples were examined. The response of the triceps brachii muscle differed significantly between the two approaches to the radial nerve (P < 0.001), and the mean intensity of stimulation was significantly lower when the nerve was accessed above the artery (0.44 AE 0.15 mA) than below it (0.57 AE 0.17 mA) (P = 0.015). A triceps brachii motor response occurs at lower current intensity and lower needle-nerve distance when the radial nerve is accessed above the artery and over the latissimus dorsi tendon. These findings were correlated with the topography of the radial nerve in the axillary fossa. Clin. Anat. 33:578-584, 2020.

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Regional Anesthesia in Children

Dalens¹

2010

Miller's Anesthesia

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Percutaneous Electrode Guidance Using the Insulated Needle for Prelocation of Peripheral Nerves During Axillary Plexus Blocks

Cited by 11 publications

References 21 publications

Effect of nerve localization using a pen device on the success of axillary brachial plexus block

Effect of nerve localization using a pen device on the success of axillary brachial plexus block

“Triceps Brachii Muscle Response to Neurostimulation of the Radial Nerve during Axillary Plexus Blockade: Clinical, Anatomical and Histological Correlation”

Regional Anesthesia in Children

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