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#35967 Nerve stimulation in nerve blocks: a still used technique, but increasingly rarely. An opportunity to reduce environmental impact in a tertiary centre in the UK?
  1. Benjamin Kidner1,
  2. Amr Hassan2 and
  3. Daniel El-Dalil2
  1. 1Anaesthetics, Nottingham University Hospitals Trust NHS, Sheffield, UK
  2. 2Anaesthetics, Nottingham University Hospitals Trust NHS, Nottingham, UK


Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Background and Aims With the introduction of ultrasound, the use of nerve stimulation to verify positioning in regional anaesthesia has become increasingly rare. Currently, needles provided as standard include an attachment to facilitate this. This attachment contains plastic and valuable metals, including copper wiring, which is ultimately discarded unused. We therefore performed a survey in our tertiary centre to assess their use.

Methods The survey was delivered to the majority of anaesthetists within Nottingham University Hospitals Trust (n=70). This involved an online questionnaire on the frequency, indications and confidence in using nerve stimulation for nerve blocks.

Results 60% of respondents were consultants and 71% of respondents stated that they would never use nerve stimulation for nerve blocks. Within the survey 21% had never used this technique and the remaining 79% showed an average time since last use of greater than 2 years. The free text answers demonstrated that many feel nerve stimulation has become unnecessary in most settings with the availability of high-quality ultrasound. However, some consultants felt that in cases where visualisation of deep tissues is challenging, this technique may be useful.

Abstract #35967 Figure 1

Last use of nerve stimulation graph, photos of needle equipment assembled and disassembled and box to demonstrate the environmental impact

Conclusions This survey demonstrates that, as expected, the use of nerve stimulation in every day practice is minimal, however, there may still be a role for nerve stimulation in certain situations such as deep blocks or obese patients. Given how infrequently nerve stimulation is used there would be a clear environmental and possible economic benefit to sourcing needles without this nerve stimulation attachment as standard.

  • Nerve stimulation
  • environment
  • needle
  • ultrasound

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