• Duk Hyun Sung.
• Department of Physical Medicine and Rehabilitation, Sungkyunkwan University School of Medicine, Samsung Medical Center, #50 Irwon-Dong, Gangnam-Gu, Seoul 136-710, Korea. dhsung@smc.samsung.co.kr
• Reg Anesth Pain Med. 2004 May 1; 29 (3): 194-200.

Background And ObjectivesThe purpose of this study is to determine how close the needle tip is placed to the target nerve using a nerve stimulator and to determine how far the injectate spreads in percutaneous nerve blocks.MethodsTwenty-four sciatic nerves of New Zealand white rabbits were located with a 2-dimensional needle manipulator and a nerve stimulator (pulse width: 100 micros for group I, 250 micros for group II). The stimulation current required to elicit a motor response for each insertion depth of the needle and the nerve-needle distance at which the required current reached the minimum were measured. Another 10 sciatic nerves were located manually using a nerve stimulator and neurolyzed with a mixed solution of 5% phenol and Indian ink (100 microL).ResultsThe nerve-needle distance was in the range of -1.2 mm to +2.8 mm in group I (1.1 +/- 0.9 mm [mean +/- standard error] in absolute value) and -0.2 mm to +4.8 mm (2.2 +/- 1.7 mm [mean +/- standard error] in absolute value) in group II (positive values signify the center of the beveled surface is past the nerve), when the stimulation current reached the minimum (average minimum current: 0.47 mA in group I, 0.37 mA in group II). Indian ink spread over a significant distance (25.4 +/- 0.5 mm [mean +/- standard error]; range, 19-31 mm) longitudinally within the perineural tissue, and axonal degeneration was observed linearly at the peripheral portion of the nerve fascicle in a similar pattern as Indian ink spread.ConclusionsThe target nerve was located within 5 mm from the needle with less than 0.5-mA stimulation current. The injectate spread to more than 20 mm on average even when a small volume (100 microL) of the injectate was injected in rabbit sciatic nerves.

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