Document Detail


Ultrasound guidance with nerve stimulation reduces the time necessary for resident peripheral nerve blockade.
MedLine Citation:
PMID:  17961845     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Educating residents in peripheral nerve blockade may impact the efficiency of a busy regional anesthesia service. Ultrasound guidance may affect the efficiency and effectiveness of nerve block. We examined the impact of ultrasound guidance on resident performance of peripheral nerve block in a regional anesthesia rotation. METHODS: An existing de-identified database was used for retrospective analysis of resident performance of interscalene, axillary, femoral, and popliteal nerve blocks, by peripheral nerve stimulator guidance alone and by nerve stimulator aided by ultrasound. The primary variable examined was the time required to perform the block. Others variables included (1) number of needle insertions; (2) proportion of blocks in which there was a blood vessel puncture; and (3) block efficacy. Peripheral nerve-stimulator blocks were guided by surface anatomy and motor stimulation, refined to 0.2 to 0.5 mA of current before injection of local anesthetic, while ultrasound nerve stimulator blocks were confirmed using a current of 0.5 mA. RESULTS: Ultrasound-aided blocks required less time to perform (median = 1.8 min) than nerve stimulator-guided blocks (median = 6.5 min, P < .001). More needle insertions were required for nerve localization in the nerve stimulator-guided blocks (median = 6) than in ultrasound-aided blocks (median = 2; P < .001). There were fewer blood vessel punctures with ultrasound-aided blocks (P = .03). CONCLUSIONS: During resident teaching, ultrasound-aided peripheral nerve-stimulated block required less time to perform than did nerve-stimulator-guided blocks. Fewer needle insertions were required to perform the ultrasound-guided blocks, and there were fewer blood vessel punctures when ultrasound was used.
Authors:
Steven L Orebaugh; Brian A Williams; Michael L Kentor
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Regional anesthesia and pain medicine     Volume:  32     ISSN:  1098-7339     ISO Abbreviation:  Reg Anesth Pain Med     Publication Date:    2007 Sep-Oct
Date Detail:
Created Date:  2007-10-26     Completed Date:  2008-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9804508     Medline TA:  Reg Anesth Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  448-54     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, UPMC-Southside, University of Pittsburgh School of Medicine, Pittsburgh, PA 15203, USA. orebaughsl@aners.upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Anesthesiology / education*
Databases, Factual
Electric Stimulation*
Humans
Internship and Residency
Medical Errors / statistics & numerical data
Motor Neurons / ultrasonography
Needles
Nerve Block*
Peripheral Nerves / anatomy & histology*,  ultrasonography*
Retrospective Studies
Treatment Failure

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


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