Use of a nerve stimulator does not improve the efficacy of ultrasound-guided supraclavicular nerve blocks

Beach, Michael L.; Sites, Brian D.; Gallagher, John D.

doi:10.1016/j.jclinane.2006.03.017

Cited by 88 publications

(33 citation statements)

References 10 publications

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“…21 Our success rate of 94.2% is comparable to other studies using a combination of ultrasound and nerve stimulation techniques. 1,2,22 However, despite the high success rate, we did have over a 5% failure rate for complete surgical block attainment. We suspect that many factors could have contributed to these failures, such as inadequate local anesthetic spread, patient body habitus, and local anesthetic soakage time.…”

Section: Discussionmentioning

confidence: 64%

“…Supraclavicular brachial plexus blocks are beneficial because of their rapid onset time and predictable anesthesia. Yet, whether the blocks are ultrasound-guided (85-95%) [1][2][3][4] or nerve stimulation-located (72-97%), 5-7 current evidence indicates variable success rates. These blocks have also been associated with pneumothorax 8,9 and procedural difficulty in patients where landmark-based techniques can be inadequate [e.g., high body mass index (BMI) or anatomical variation].…”

Section: Résumémentioning

confidence: 99%

“…Body mass index [(weight(kg)/height 2 (m) 2 ] was recorded when available, and the patients were then classified as morbidly obese (C40 kg m -2 ), obese (30-39.9 kg m -2 ), overweight (25-29.9 kg m -2 ), or normal weight (B24.9 kg m -2 ). 1 The success rate and block completion times were compared between groups of patients based on BMI and on experience level of block performer. All patients were discharged with a patient care pamphlet and were instructed to report any breathing difficulties and/or prolonged anesthesia by calling a 24 h contact number.…”

Section: Review Of Clinical Seriesmentioning

confidence: 99%

“…Injection of 1-2 ml of D5W confirms spread of solution, while maintaining the motor response during a nerve stimulation technique. 1 Nerve stimulation responses (hand or wrist movement at a current threshold of 0.5 mA) were used for confirmation of the nerve structure. Ultrasonographic visibility of close needleplexus proximity and appropriate spread of solution (Fig.…”

Section: Combined Usnsg Supraclavicular Blockmentioning

confidence: 99%

See 3 more Smart Citations

Case series: ultrasound-guided supraclavicular block using a curvilinear probe in 104 day-case hand surgery patients

Tsui

Doyle

Chu

et al. 2008

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 64%

Section: Résumémentioning

confidence: 99%

Section: Review Of Clinical Seriesmentioning

confidence: 99%

Section: Combined Usnsg Supraclavicular Blockmentioning

confidence: 99%

See 2 more Smart Citations

Case series: ultrasound-guided supraclavicular block using a curvilinear probe in 104 day-case hand surgery patients

Tsui

Doyle

Chu

et al. 2008

Can J Anesth/J Can Anesth

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“…This may further decrease the likelihood of catheter advancement away from the tract formed by the injected dextrose solution, thereby improving the ease of catheter insertion (Niazi et al, 2009). To date, however, the need for electro-stimulation in addition to ultrasound guidance remains controversial, especially for lower extremity perineural catheter placement (Chan et al, 2007;Walker & Roberts, 2007;Beach et al, 2006;Gürkan et al, 2008;Dingemans et al, 2007). Moreover combining ultrasound with electro-stimulation does negate any cost advantages attributed to ultrasound guidance alone (Sandhu et al, 2004).…”

Section: An Alternative: Ultrasonographic Guidancementioning

confidence: 99%

Efficacy of Continuous Femoral Nerve Block with Stimulating Catheters Versus Nonstimulating Catheters - A Systematic-Narrative Review

Dauri¹,

Celidonio²,

Nahmias³

et al. 2012

Pain Management - Current Issues and Opinions

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IntroductionA femoral nerve block is simple to perform, has a high rate success, carries a low risk of complications, and it is widely used technique for surgical anesthesia and post-operative pain management of the lower extremity. It provides analgesia to the anterior thigh, including the flexor muscles of the hip and extensor muscles of the knee and therefore, it is well suited for surgeries that involve the hip, the knee or the anterior thigh zone. The femoral nerve block is often associated with sciatic nerve block in order to achieve a lower extremity analgesia. The anterior approach to the femoral nerve block initially described as a 3-in-1 block by Winnie et al (Winnie et al., 1973), suggested that the femoral, lateral femoral cutaneous, and obturator nerves could be blocked from a single paravascular injection at a point inferior to the inguinal crease. Studies have since showed that the femoral can be reliably blocked by a single injection, the lateral femoral cutaneous nerves is blocked in 95%, but the obturator nerve is almost always spared (Parkinson et al., 1989). Therefore, a 3-in-1 block with the paravascular approach seems difficult to obtain, and, as a consequence, when all three nerves need to be anesthetized a posterior lumbar plexus block or a multitruncular block should be performed. The anterior approach to the femoral nerve is similar for "single shot" or continuous nerve blocks. A femoral nerve block can be obtained with single shot of local anesthetic or by using a continuous catheter technique. The localization of the femoral nerve can be obtained by the use of nerve stimulator or with ultrasound guidance. When using single shot technique, the local anesthetic agent is injected through the needle after location of the nerve with the nerve stimulator. When using continuous catheter techniques, the nerve can be stimulated via the needle through which the catheter is placed, or via both the needle and the catheter itself. This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) and retrospective analysis, in order to determine the efficacy of continuous femoral nerve block comparing the use of stimulating catheters with non-stimulating catheters for lower-extremity surgery. Furthermore, we explore the adjunctive use of ultrasonography for femoral nerve block.

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The Thoracic Limb

Campoy¹,

Read²

2013

Small Animal Regional Anesthesia and Analgesia

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Use of a nerve stimulator does not improve the efficacy of ultrasound-guided supraclavicular nerve blocks

Cited by 88 publications

References 10 publications

Case series: ultrasound-guided supraclavicular block using a curvilinear probe in 104 day-case hand surgery patients

Case series: ultrasound-guided supraclavicular block using a curvilinear probe in 104 day-case hand surgery patients

Efficacy of Continuous Femoral Nerve Block with Stimulating Catheters Versus Nonstimulating Catheters - A Systematic-Narrative Review

The Thoracic Limb

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