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Reg Anesth Pain Med · May 2009
Implications of a permanent cardiac pacemaker in peripheral nerve blockade.
- Baskar P Manickam and Richard Brull.
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Ontario, Canada.
- Reg Anesth Pain Med. 2009 May 1;34(3):233-5.
AbstractPatients with permanent cardiac pacemakers (PPMs) are vulnerable to electromagnetic interference from electrical equipment used in the operating room environment. Electromagnetic interference may lead to PPM malfunction with potential harmful effects to the patient. Conventional techniques for peripheral nerve blockade include the use of electrical nerve stimulation (NS) for nerve localization. The hazards of NS, especially when applied near the implanted PPM sites, are not known. In the absence of available guidelines regarding the safe use of NS in the setting of an implanted PPM, we recommend a combined guidance approach for peripheral nerve blockade using ultrasound for nerve localization along with low-current NS for nerve identification.
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