Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialProspective comparison of continuous femoral nerve block with nonstimulating catheter placement versus stimulating catheter-guided perineural placement in volunteers.
Stimulating catheter-guided perineural placement may potentially increase the success rate and quality of continuous femoral nerve block as compared with a nonstimulating catheter technique. These hypotheses have not been rigorously tested. ⋯ In this volunteer study, there was no statistically significant difference in block success between the two techniques. However, stimulating catheter-guided placement provided an increased overall quality of continuous femoral perineural blockade. Further studies are needed to verify these observations in the clinical setting.
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Reg Anesth Pain Med · May 2004
Case ReportsElectrical nerve stimulation using a stimulating catheter: what is the lower limit?
To minimize the risk of intraneural injection when performing nerve blocks, some authors caution against injecting through a needle placed with motor responses observed at nerve stimulator output settings of 0.3 mA or less. We present a case of placing a continuous cervical paravertebral catheter with brisk motor response while stimulating the catheter at 0.05 mA, with no adverse sequelae. ⋯ We present a single case of successful placement of a stimulating catheter with no neurological injury even when motor response occurred at very low nerve stimulator output settings.
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Reg Anesth Pain Med · May 2004
Percutaneous electrode guidance using the insulated needle for prelocation of peripheral nerves during axillary plexus blocks.
Short reports have noted that percutaneous prelocation is helpful in determining the anatomic course of a peripheral nerve, and, thereby, may serve as a guide for block needle insertion. We prospectively studied percutaneous electrode guidance to assist axillary brachial plexus blocks. ⋯ Percutaneous electrode guidance using the insulated needle enabled clinicians to locate the terminal branches of the plexus in the axilla and appreciate their depth. This method could, therefore, minimize patient discomfort and perhaps the risk of nerve trauma.