• Martin Zoremba, Hinnerk Wulf, Thorsten Steinfeldt, Frank Dette, Sabine Poeschl, Wilhelm Nimphius, and Hans-Helge Mueller.
• Philipps University, Department of Anaesthesiology and Intensive Care Therapy, University Hospital Giessen-Marburg, Campus Marburg, Baldingerstrasse, 35032 Marburg, Germany. steinfeldt@gmx.de
• Anesth. Analg.. 2011 Aug 1;113(2):417-20.

BackgroundIn this study, we determined whether needle advancement during needle-nerve contact (forced needle-nerve contact) is associated with a higher risk of nerve injury compared with needle-nerve contact without needle advancement (nonforced needle-nerve contact).MethodsIn 8 anesthetized pigs, the brachial plexus nerves underwent forced (0.15 Newton) or nonforced (0.0 Newton) needle-nerve contact without nerve penetration. The grade of nerve injury was histologically assessed using an objective score ranging from 0 (no injury) to 4 (severe injury).ResultsSixty-nine nerves, including controls, were examined. Histology revealed a significant difference between forced and nonforced needle-nerve contact (median [interquartile range] 3 [2-4] vs 2 [1-2]; P = 0.004). Myelin damage and intraneural hematoma occurred only after forced needle-nerve contact.ConclusionsThe severity of structural nerve injury after needle-nerve contact was directly related to force exposure via needle advancement.

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