Background and Objectives This study evaluated the efficacy of stimulating catheters used for continuous peripheral nerve blocks as a means of immediate verification and confirmation of correct catheter position.
Methods This observational study presents our experience with 130 stimulating catheters used in 40 intersternocleidomastoid, 24 axillary, 47 femoral, and 19 lateral midfemoral sciatic nerve blocks. Placement characteristics (amperage, depth of introducer needle or catheter insertion, elicited motor responses), subsequent postoperative analgesia, and catheter position evaluated with the radiopaque dye analysis were all studied.
Results Except in femoral blocks, characteristics of motor responses elicited (1 Hz, 0,1 ms) by the introducer assembly and catheter differed. The amperage required to elicit motor responses typically was higher with the catheter than with the introducer needle (1.6 [0.2 to 4 mA] v 0.5 [0.4 to 1 mA] P < .0001). The ability to elicit a motor response with the stimulating catheter correlated with successful clinical anesthesia in 124 cases. Opacified radiography showed no aberrant position in these cases. Three catheters for upper limb block failed to stimulate, provided poor anesthesia, and had radiologic evidence of aberrant position. Even though they failed to stimulate, 3 catheters for sciatic block functioned well, and the opacified radiography showed correct position.
Conclusion The ability to electrostimulate nerves using an in situ catheter increases success rate in catheter placement for continuous peripheral nerve blocks. Further controlled investigations are necessary to compare this technique with more conventional methods in terms of cost and utility for various peripheral nerve blocks. Reg Anesth Pain Med 2003;28:83-88.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Presented in part at American Society of Anesthesiologists meeting, Orlando, FL, October 17-21, 1998 and the Société Française d’Anesthésie-Réanimation, Paris, France, September 20-23, 2001.