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2008, Number 2

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Rev Med Hosp Gen Mex 2008; 71 (2)

Peripheral nerve stimulator: Neurolocalization alternative method of nerve plexus in regional anesthesia

López-Herranz GP

Language: Spanish
References: 33
Page: 103-108
PDF size: 135.70 Kb.


ABSTRACT

Nerve stimulation for peripheral and plexus nerve block, is a few alternative used in our country, that offers advantages in comparison with other techniques of nervous location in regional anesthesia. The neurolocalization consists of the correct positioning of the end of the needle in the proximity of the nerve, and its identification with certain exactitude to achieve success in the nervous blockade. It can be made by several methods like palpation, synchronous beat, fascial click, transarterial, elicited paresthesia, by imaging, and with nerve stimulation. The search of paresthesia involves patient collaboration and an unpleasant sensation, with potential risk of nervous injury. The peripheral nerve stimulation (PNS) or neuroestimulation, is an alternative direct method for the identification and peripheral location of the motor component of one or several nerves by means of a continuous electrical current through the needle, that produces a muscular contraction when approaching the nerve, with less probabilities of nervous injury. The election of a neurolocalization method, depends on the personal preference and experience of the anesthesiologist. The purpose of this review consists of describing the basic concepts of the peripheral nervous stimulation (PNS), neuroelectrophisyological basis, stimulating needles characteristics, technique, advantages, and innovations of this method of neurolocalization.


REFERENCES

  1. Murphy TM. Bloqueos nerviosos. En: Miller RD, editor. Anestesia. 2a ed. Barcelona: Ediciones Doyma, 1988; vol 2: 947-948.

  2. Pere P, Pitkanen M, Tuominen M, Edgren J, Rosenberg PH. Clinical and radiological comparison of perivascular and transarterial techniques of axillary brachial plexus block. Br J Anaesth 1993; 70: 276-279.

  3. Nishiyama M, Naganuma K, Amaki Y. A new approach for brachial plexus block under fluoroscopic guidance. Anesth Analg 1999; 88: 91-97.

  4. Sabbatini RME. The discovery of bioelectricity. URL: http: //www.cerebromente.org.br (Consultado 5/08/07).

  5. Montgomery SJ, Raj PP, Nettles D, Jenkins MT. The use of the nerve stimulator with standard unsheathed needles in nerve blockade. Anesth Analg 1973; 52: 827-831.

  6. Franco CD, Domashevich V, Voronov G, Rafizad AB, Jelev TJ. The supraclavicular block with a nerve stimulator: To decrease or not to decrease, that is the question. Anesth Analg 2004; 98: 1168-1171.

  7. Greenblatt GM, Denson JS. Needle nerve stimulator-locator: Nerve blocks with a new instrument for locating nerves. Anesth Analg 1962; 41: 599-602.

  8. Magora F, Rozin R, Ben-MenachemY, Magora A. Obturator nerve block: an evaluation of technique. Br J Anaesth 1969; 41: 695-698.

  9. Yasuda I, Hirano T, Ojima T, Ohira N, Kaneko T, Yamamuro M. Supraclavicular brachial plexus block using a nerve stimulator and an uninsulated needle. Br J Anesth 1980, 52: 409-411.

  10. Galindo A. Special needles for nerve blocks. Reg Anesth 1980; 5: 12-13.

  11. Hadzic A, Vloka J, Hadzic N, Thys DM, Santos AC. Nerve stimulators used for peripheral nerve blocks vary in their electrical characteristics. Anesthesiology 2003; 98: 969-974.

  12. Jochum D, Iohom G, Diarra DP, Loughnane F, Dupré LJ, Bouaziz H. An objective assessment of nerve stimulators used for peripheral nerve blockade. Anaesthesia 2006; 61: 557-564.

  13. Guyton AC. Potenciales de membrana, potenciales de acción, excitación y ritmicidad. En: Guyton AC (ed). Tratado de Fisiología Médica. 5a ed. México: Nueva Editorial Interamericana, 1977: 116, 126-127.

  14. Ley de Coulomb. URL: http: //es.wikipedia.org/wiki/Ley_de_ Coulomb (Consultado 5/08/07).

  15. Urmey WF. Using the nerve stimulator for peripheral or plexus nerve blocks. Minerva Anesthesiol 2006 Jun; 72 (6): 467-471.

  16. Tulchinsky A, Weller RS, Rosemblum M, Gross JB. Nerve stimulator polarity and brachial plexus block. Anesth Analg 1993; 77: 100-103.

  17. Jones RP, De Jonge M, Smith BE. Voltage fields surrounding needles uses in regional anaesthesia. Br J Anaesth 1992; 68: 515-518.

  18. Ford DJ, Pither C, Raj PP. Comparison of insulated and uninsulated needles for locating peripheral nerves with a peripheral nerve stimulator. Anesth Analg 1984; 63: 925-928.

  19. Bashein G, Haschke RH, Ready LB. Electrical nerve location: Numerical and electrophoretic comparison of insulated vs uninsulated needles. Anesth Analg 1984; 63: 919-924.

  20. Johnson CR, Barr RC, Klein SM. A computer model of electrical stimulation of peripheral nerves in regional anesthesia. Anesthesiology 2007; 106: 323-230.

  21. Hadzic A, Vloka J, Claudio RE, Hadzic N, Thys DM, Santos AC. Electrical nerve localization. Effects of cutaneous electrode placement and duration of the stimulus on motor response. Anesthesiology 2004; 100: 1526-1530.

  22. Raj PP, Montgomery, SJ, Nettles D, Jenkins MT. Infraclavicular brachial plexus block-a new approach. Anesth Analg 1973; 52: 897-904.

  23. Zeh DW, KatzRL. A new nerve stimulator for monitoring neuromuscular blockade and performing nerve blocks. Anesth Analg 1978; 57: 13-17.

  24. Bosenberg AT. Lower limb nerve blocks in children using unsheathed needles and a nerve stimulator. Anaesthesia 1995; 50: 206-210.

  25. Urmey WP, Grossi P. Percutaneous electrode guidance: A noninvasive technique for prelocation of peripheral nerves for facilitate peripheral plexus or nerve block. Reg Anesth Pain Med 2002; 27: 261-267.

  26. Wehling MJ, Koorn R, Leddell C, Boezaart AP. Electrical nerve stimulation using a stimulating catheter: What is the lower limit? Reg Anesth Pain Med 2004; 29: 230-233.

  27. Goldberg ME, Gregg C, Larijani GE, Norris MC,Marr AT, Seltzer JL. A comparison of three methods of axillary approach to brachial plexus blockade for upper extremity surgery. Anesthesiology 1987; 66: 814-816.

  28. Liguori GA, Zayas VM, YaDeau JT, Kahn RL, Paroli L, Buschiazzo V, et al. Nerve localization techniques for interscalene brachial plexus blockade: A prospective, randomized comparison of mechanical paresthesia versus electrical stimulation. Anesth Analg 2006; 103: 761-767.

  29. Davies MJ, McGlade DP. One hundred sciatic nerve blocks: A comparison of localization techniques. Anaesth Intens Care 1993; 21: 76-78.

  30. Sia S, Bartoli M, Lepri A, Marchini O, Ponsecchi P. Multiple-injection axillary brachial plexus block: A comparison of two methods of nerve localization-nerve stimulation versus paresthesia. Anesth Analg 2000; 91: 647-651.

  31. Perlas A, Chan VWS, Simons S. Brachial plexus examination and localization using ultrasound and electrical stimulation. Anesthesiology 2003; 99: 429-435.

  32. Casati A, Danelli G, Baciarello M, Corradi M, Leone S, Di Cianni S, y cols. A prospective, randomized comparison between ultrasound and nerve stimulation guidance for multiple injection axillary brachial plexus block. Anesthesiology 2007; 106: 992-996.

  33. Borgeat A, Ekatodramis G, Kalberer F, Benz C. Acute and nonacute complications associated with interscalene block and shoulder surgery. A prospective study. Anesthesiology 2001; 95: 875-880.




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