Document Detail


Guidance of block needle insertion by electrical nerve stimulation: a pilot study of the resulting distribution of injected solution in dogs.
MedLine Citation:
PMID:  18719445     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little is known regarding the final needle tip location when various intensities of nerve stimulation are used to guide block needle insertion. Therefore, in control and hyperglycemic dogs, the authors examined whether lower-intensity stimulation results in injection closer to the sciatic nerve than higher-threshold stimulation.
METHODS: During anesthesia, the sciatic nerve was approached with an insulated nerve block needle emitting either 1 mA (high-current group, n = 9) or 0.5 mA (low-current group, n = 9 in control dogs and n = 6 in hyperglycemic dogs). After positioning to obtain a distal motor response, the lowest current producing a response was identified, and ink (0.5 ml) was injected. Frozen sections of the tissue revealed whether the ink was in contact with the epineurium of the nerve, distant to it, or within it.
RESULTS: In control dogs, the patterns of distribution using high-threshold (final current 0.99 +/- 0.03 mA, mean +/- SD) and low-threshold (final current 0.33 +/- 0.08 mA) stimulation equally showed ink that was in contact with the epineurium or distant to it. One needle placement in the high-threshold group resulted in intraneural injection. In hyperglycemic dogs, all needle insertions used a low-threshold technique (n = 6, final threshold 0.35 +/- 0.08 mA), and all resulted in intraneural injections.
CONCLUSIONS: In normal dogs, current stimulation levels in the range of 0.33-1.0 mA result in needle placement comparably close to the sciatic nerve but do not correlate with distance from the target nerve. In this experimental design, low-threshold electrical stimulation does not offer satisfactory protection against intraneural injection in the presence of hyperglycemia.
Authors:
Marcel Rigaud; Patrick Filip; Philipp Lirk; Andreas Fuchs; Geza Gemes; Quinn Hogan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  109     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-22     Completed Date:  2008-09-30     Revised Date:  2014-09-20    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  473-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Coloring Agents / administration & dosage*,  pharmacokinetics
Disease Models, Animal
Dogs
Electric Stimulation / methods*
Hyperglycemia / physiopathology*
Models, Animal
Needles*
Peripheral Nerves / physiology,  physiopathology
Pilot Projects
Random Allocation
Sciatic Nerve / physiology,  physiopathology*
Grant Support
ID/Acronym/Agency:
R01 NS042150/NS/NINDS NIH HHS; R01 NS042150-04/NS/NINDS NIH HHS; R01 NS042150-05A2/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Coloring Agents
Comments/Corrections
Comment In:
Anesthesiology. 2009 Jun;110(6):1421; author reply 1421   [PMID:  19461305 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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