Publikationsserver der Universitätsbibliothek Marburg

Titel:Der Einfluss der unisolierten Stromemissionsfläche an der Stimulationskanülenspitze während der Nervenlokalisation zur peripheren Regionalanästhesie
Autor:Wichmann, Julia
Weitere Beteiligte: Steinfeldt, Thorsten (Prof. Dr.)
Veröffentlicht:2016
URI:https://archiv.ub.uni-marburg.de/diss/z2016/0430
URN: urn:nbn:de:hebis:04-z2016-04301
DOI: https://doi.org/10.17192/z2016.0430
DDC:610 Medizin
Titel (trans.):The impact of the non-insulated current emitting-surface of the stimulation-needle during nerve localization for peripheral regional anesthesia
Publikationsdatum:2016-06-30
Lizenz:https://creativecommons.org/licenses/by-nc-sa/4.0

Dokument

Schlagwörter:
Nervenlokalisation, Regionalanästhesie, nerve localization, needle-nerve-contact, regional anesthesia, Nadel-Nerv-Kontakt, Nervenstimulation

Zusammenfassung:
Einleitung: Die elektrische Nervenstimulation ist ein etabliertes Standardverfahren zur Nervenlokalisation bei der Durchführung peripherer Nervenblockaden. Neurologische Defizite nach peripheren Regionalanästhesien lassen sich jedoch trotz Berücksichtigung vermeintlich nervenschonender Techniken bisher nicht vollends vermeiden und stellen ein klinisch relevantes Problem dar. Als häufige Ursache wird die Nervenverletzung während der Kanülenplatzierung diskutiert. Nadel-Nerv-Kontakte gelten als gesicherter Risikofaktor für Nervenschäden. Die verfügbaren Designs isolierter Stimulationskanülen unterscheiden sich zum Teil beträchtlich in der Größe ihrer Stromemissionsfläche. Bisher liegen keine vergleichenden Daten zur Inzidenz von Nadel-Nerv-Kontakten in Abhängigkeit von der Emissionsfläche vor. Material und Methoden: An sechs anästhesierten Schweinen wurde am offenen Plexus brachialis eine Nadel-Nerv-Distanzmessung bei minimaler Reizantwort unter Anwendung eines Schwellenstroms von 0,3 bis 0,8 mA durchgeführt. Es wurden drei Kanülentypen untersucht: Stimuplex® A (Standardkanüle mit mittlerer Emissionsfläche, n = 2025), Stimuplex® D (kleine Emissionsfläche, n = 1800) und eine Tuohy-Kanüle (StimucathTM, große Emissionsfläche, n = 2025). Die relativen Häufigkeiten für Nadel-Nerv-Kontakte wurden mittels Fishers Exact Test verglichen. Unterschiede zwischen den Nadel-Nerv-Abständen wurden mittels Friedman-Test und anschließendem Paarvergleich ermittelt. Ergebnisse: Insgesamt wurden 5850 Stimulationsversuche durchgeführt. Im Intervall 0,3 - 0,5 mA fand sich eine hohe Anzahl an unerwünschten Nadel-Nerv-Kontakten. Im Niedrigstrombereich traten zudem Nadel-Nerv-Kontakte ohne begleitende Stimulationsantwort auf. Die höchste Stimulationsversagerrate wies die Tuohy-Kanüle auf, gefolgt von der Stimuplex® D und der Stimuplex® A. Der Unterschied zwischen den untersuchten Nadeltypen war signifikant (p < 0,0001 für 0,3 mA). Im Intervall 0,6 - 0,8 mA wies die Stimuplex® A die geringste Inzidenz von Nadel-Nerv-Kontakten auf und unterschied sich signifikant von den beiden anderen Kanülen (Stimuplex® A vs. Stimuplex® D p < 0,005 für 0,6 mA, p < 0,0001 für 0,7 mA, p < 0,005 für 0,8 mA, Stimuplex® A vs. Tuohy p < 0,0001 für 0,6 mA bis 0,8 mA). Für die Tuohy-Nadel zeigte sich im Vergleich zur Stimuplex® D eine höhere Inzidenz von Nadel-Nerv-Kontakten. Schlussfolgerung: Beim Einsatz von Stimulationskanülen mit kleinen Emissionsflächen treten Nadel-Nerv-Kontakte nicht seltener auf als bei der Verwendung von Kanülen mit großen Emissionsflächen. Dennoch implizieren die signifikanten Unterschiede in der Inzidenz von Nadel-Nerv-Kontakten mit und ohne Stimulationserfolg differente Stimulationseigenschaften der unterschiedlichen Kanülenmodelle. Das Tuohy-Design scheint besonders anfällig für Nadel-Nerv-Kontakte und das Ausbleiben einer Reizantwort bei unmittelbarer Berührung des Zielnerven. Bei Stimulation mit Strömen oberhalb von 0,5 mA ist im Vergleich zu niedrigeren Schwellenwerten unabhängig vom Kanülendesign von einer größeren Sicherheit durch seltenere Nadel-Nerv-Kontakte bei vergleichbarer Nähe der Stimulationsnadel zum Nerv auszugehen. Darüber hinaus variiert der optimale Stimulationsstrom in Abhängigkeit vom verwendeten Kanülentyp.

Bibliographie / References

  1. Davis JC, Anderson NE, Ramirez JG et al. (2007) Finite-difference modeling of the anisotropic electric fields generated by stimulating needles used for catheter placement. IEEE Trans Biomed Eng 54:1186-1190
  2. Chan VW, Brull R, McCartney CJ et al. (2007) An ultrasonographic and histological study of intraneural injection and electrical stimulation in pigs. Anesth Analg 104:1281-1284
  3. Robards C, Hadzic A, Somasundaram L et al. (2009) Intraneural injection with low-current stimulation during popliteal sciatic nerve block. Anesth Analg 109:673-677
  4. 40. Chambers WA (1992) Peripheral nerve damage and regional anaesthesia. Br J Anaesth 69:429-430
  5. Aitkenhead AR (2005) Injuries associated with anaesthesia. A global perspective. Br J Anaesth 95:95-109
  6. Abrahams MS, Aziz MF, Fu RF et al. (2009) Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials. Br J Anaesth 102:408-417
  7. Borgeat A, Blumenthal S (2004) Nerve injury and regional anaesthesia. Curr Opin Anaesthesiol 17:417-421
  8. van Geffen GJ, McCartney CJ, Gielen M et al. (2007) Ultrasound as the only nerve localization technique for peripheral nerve block. J Clin Anesth 19:381- 385
  9. Singelyn FJ, Deyaert M, Joris D et al. (1998) Effects of intravenous patient- controlled analgesia with morphine, continuous epidural analgesia, and continuous three-in-one block on postoperative pain and knee rehabilitation after unilateral total knee arthroplasty. Anesth Analg 87:88-92
  10. Barrington MJ, Watts SA, Gledhill SR et al. (2009) Preliminary results of the Australasian Regional Anaesthesia Collaboration: a prospective audit of more than 7000 peripheral nerve and plexus blocks for neurologic and other complications. Reg Anesth Pain Med 34:534-541
  11. Swindle MM, Smith AC, Hepburn BJ (1988) Swine as models in experimental surgery. J Invest Surg 1:65-79 ! 81!
  12. Geddes LA (2004) Accuracy limitations of chronaxie values. IEEE Trans Biomed Eng 51:176-181
  13. Johnson CR, Barr RC, Klein SM (2007) A computer model of electrical stimulation of peripheral nerves in regional anesthesia. Anesthesiology 106:323-330
  14. Borgeat A, Ekatodramis G, Kalberer F et al. (2001) Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology 95:875-880
  15. Volk T, Engelhardt L, Spies C et al. (2009) [A German network for regional anaesthesia of the scientific working group regional anaesthesia within DGAI and BDA]. Anasthesiol Intensivmed Notfallmed Schmerzther 44:778-780
  16. Ongoïba N, Destrieux C, Koumare AK (2002) Anatomical variations of the brachial plexus. Morphologie 86:31-34
  17. Schiebler T (2007) Anatomie: Histologie, Entwicklungsgeschichte, makroskopische und mikroskopische Anatomie. Steinkopff
  18. Carles M, Pulcini A, Macchi P et al. (2001) An evaluation of the brachial plexus block at the humeral canal using a neurostimulator (1417 patients): the efficacy, safety, and predictive criteria of failure. Anesth Analg 92:194-198
  19. Wright BD (1969) A new use for the block-aid monitor. Anesthesiology 30:236- 237
  20. Jochum D, Iohom G, Diarra DP et al. (2006) An objective assessment of nerve stimulators used for peripheral nerve blockade*. Anaesthesia 61:557-564
  21. Dufour E, Cymerman A, Nourry G et al. (2010) An ultrasonographic assessment of nerve stimulation-guided median nerve block at the elbow: a local anesthetic spread, nerve size, and clinical efficacy study. Anesth Analg 111:561-567
  22. Sala-Blanch X, Vandepitte C, Laur JJ et al. (2011) A practical review of perineural versus intraneural injections: a call for standard nomenclature. Int Anesthesiol Clin 49:1-12
  23. Hebl JR, Dilger JA, Byer DE et al. (2008) A pre-emptive multimodal pathway featuring peripheral nerve block improves perioperative outcomes after major orthopedic surgery. Reg Anesth Pain Med 33:510-517
  24. Ironfield CM, Barrington MJ, Kluger R et al. (2014) Are patients satisfied after peripheral nerve blockade? Results from an International Registry of Regional Anesthesia. Reg Anesth Pain Med 39:48-55
  25. Eifert B, Hähnel J, Kustermann J (1994) Axillary blockade of the brachial plexus. A prospective study of blockade success using electric nerve stimulation. Anaesthesist 43:780-785
  26. Perthes G (1912) Über Leitungsanästhesie unter Zuhilfenahme elektrischer Reizung. Münchener Medizinische Wochenschrift:2545-2551
  27. Klein SM, Nielsen KC (2003) Brachial plexus blocks: infusions and other mechanisms to provide prolonged analgesia. Curr Opin Anaesthesiol 16:393- 399
  28. Hadzic A, Dilberovic F, Shah S et al. (2004) Combination of intraneural injection and high injection pressure leads to fascicular injury and neurologic deficits in dogs. Reg Anesth Pain Med 29:417-423
  29. Ford DJ, Pither C, Raj PP (1984) Comparison of insulated and uninsulated needles for locating peripheral nerves with a peripheral nerve stimulator. Anesth Analg 63:925-928
  30. Faccenda KA, Finucane BT (2001) Complications of regional anaesthesia Incidence and prevention. Drug Saf 24:413-442
  31. Cantrell MB, Grill WM, Klein SM (2009) Computer-based finite element modeling of insulated Tuohy needles used in regional anesthesia. Anesthesiology 110:1229-1234
  32. Bingham AE, Fu R, Horn JL et al. (2012) Continuous peripheral nerve block compared with single-injection peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials. Reg Anesth Pain Med 37:583- 594
  33. Capdevila X, Pirat P, Bringuier S et al. (2005) Continuous peripheral nerve blocks in hospital wards after orthopedic surgery: a multicenter prospective analysis of the quality of postoperative analgesia and complications in 1,416 patients. Anesthesiology 103:1035-1045
  34. Wei XF, Grill WM (2005) Current density distributions, field distributions and impedance analysis of segmented deep brain stimulation electrodes. J Neural Eng 2:139-147
  35. Rubinstein JT, Spelman FA, Soma M et al. (1987) Current density profiles of surface mounted and recessed electrodes for neural prostheses. IEEE Trans Biomed Eng 34:864-875
  36. Sauter AR, Dodgson MS, Kalvøy H et al. (2009) Current threshold for nerve stimulation depends on electrical impedance of the tissue: a study of ultrasound-guided electrical nerve stimulation of the median nerve. Anesth Analg 108:1338-1343
  37. Bhadra N, Kilgore KL (2004) Direct current electrical conduction block of peripheral nerve. IEEE Trans Neural Syst Rehabil Eng 12:313-324
  38. Richman JM, Liu SS, Courpas G et al. (2006) Does continuous peripheral nerve block provide superior pain control to opioids? A meta-analysis. Anesth Analg 102:248-257
  39. Vassiliou T, Eider J, Nimphius W et al. (2012) Dual guidance improves needle tip placement for peripheral nerve blocks in a porcine model. Acta Anaesthesiol Scand 56:1156-1162
  40. Kehlet H (1996) Effect of pain relief on the surgical stress response. Reg Anesth 21:35-37
  41. Guha SK, Khan MR, Tandon SN (1973) Electrical field distribution in the human body. Phys Med Biol 18:712-720 ! 74! 80. Hadzic A (2004) Peripheral nerve stimulators: cracking the code--one at a time. Reg Anesth Pain Med 29:185-188
  42. Tsui BC, Pillay JJ, Chu KT et al. (2008) Electrical impedance to distinguish intraneural from extraneural needle placement in porcine nerves during direct exposure and ultrasound guidance. Anesthesiology 109:479-483
  43. Hadzic A, Vloka JD, Claudio RE et al. (2004) Electrical nerve localization: effects of cutaneous electrode placement and duration of the stimulus on motor response. Anesthesiology 100:1526-1530
  44. Bashein G, Haschke RH, Ready LB (1984) Electrical nerve location: numerical and electrophoretic comparison of insulated vs uninsulated needles. Anesth Analg 63:919-924
  45. Neuburger M, Rotzinger M, Kaiser H (2001) Electric nerve stimulation in relation to impulse strength. A quantitative study of the distance of the electrode point to the nerve. Anaesthesist 50:181-186 ! 78!
  46. Tsui BC, Wagner A, Finucane B (2004) Electrophysiologic effect of injectates on peripheral nerve stimulation. Reg Anesth Pain Med 29:189-193
  47. Aminoff MJ (2004) Electrophysiologic testing for the diagnosis of peripheral nerve injuries. Anesthesiology 100:1298-1303
  48. Urban MK, Urquhart B (1994) Evaluation of brachial plexus anesthesia for upper extremity surgery. Reg Anesth 19:175-182
  49. Hirasawa Y, Katsumi Y, Küsswetter W et al. (1990) Experimental studies on peripheral nerve injuries caused by injection needles. Reg Anaesth 13:11-15
  50. Bigeleisen PE, Moayeri N, Groen GJ (2009) Extraneural versus intraneural stimulation thresholds during ultrasound-guided supraclavicular block. Anesthesiology 110:1235-1243
  51. Carrero G (2003) Fascicular anatomy, nervi nervorum, and paresthesia. Reg Anesth Pain Med 28:72-73
  52. Steinfeldt T, Poeschl S, Nimphius W et al. (2011) Forced needle advancement during needle-nerve contact in a porcine model: histological outcome. Anesth Analg 113:417-420
  53. B. Braun AG, Deutschland (2013) Gesamtkatalog Regionalanästhesie. pp 10, 28
  54. Steinfeldt T, Graf J, Vassiliou T et al. (2009) High or low current threshold for nerve stimulation for regional anaesthesia. Acta Anaesthesiol Scand 53:1275- 1281
  55. Vassiliou T, Müller HH, Ellert A et al. (2013) High-versus low-stimulation current threshold for axillary plexus blocks: a prospective randomized triple- blinded noninferiority trial in 205 patients. Anesth Analg 116:247-254
  56. Kaiser H, Neuburger M (2002) How close is close enough--how close is safe enough. Reg Anesth Pain Med 27:227-228 ! 75! 96. Kaiser H, Niesel HC, Hans V (1990) Fundamentals and requirements of peripheral electric nerve stimulation. A contribution to the improvement of safety standards in regional anesthesia. Reg Anaesth 13:143-147
  57. Urmey WF, Stanton J (2002) Inability to consistently elicit a motor response following sensory paresthesia during interscalene block administration. Anesthesiology 96:552-554
  58. Sites BD, Taenzer AH, Herrick MD et al. (2012) Incidence of local anesthetic systemic toxicity and postoperative neurologic symptoms associated with 12,668 ultrasound-guided nerve blocks: an analysis from a prospective clinical registry. Reg Anesth Pain Med 37:478-482
  59. März P (1990) In electric nerve stimulation can the distance from the nerves be inferred from the intensity of muscle contraction? Possible parameters and sources of error. Reg Anaesth 13:179-185
  60. Neuburger M, Gültlinger O, Ass B et al. (2005) Influence of blockades with local anesthetics on the stimulation ability of a nerve by peripheral nerve stimulation. Results of a randomized study. Anaesthesist 54:575-577
  61. Kaiser H, Niesel HC, Klimpel L (1988) Influence of minimum current for peripheral nerve stimulation on the latency and success rate of sciatic blockade. Reg Anaesth 11:92-97
  62. Tsai TP, Vuckovic I, Dilberovic F et al. (2008) Intensity of the stimulating current may not be a reliable indicator of intraneural needle placement. Reg Anesth Pain Med 33:207-210
  63. Silverstein WB, Saiyed MU, Brown AR (2000) Interscalene block with a nerve stimulator: a deltoid motor response is a satisfactory endpoint for successful block. Reg Anesth Pain Med 25:356-359
  64. Gadsden J, Gratenstein K, Hadzic A (2010) Intraneural injection and peripheral nerve injury. Int Anesthesiol Clin 48:107-115
  65. Saranteas T, Karakitsos D, Alevizou A et al. (2008) Limitations and technical considerations of ultrasound-guided peripheral nerve blocks: edema and subcutaneous air. Reg Anesth Pain Med 33:353-356
  66. Neuburger M, Schwemmer U, Volk T et al. (2014) Localization of peripheral nerves. Success and safety with electrical nerve stimulation. Anaesthesist 63:422-428
  67. Sung DH (2004) Locating the target nerve and injectate spread in rabbit sciatic nerve block. Reg Anesth Pain Med 29:194-200
  68. Szerb J, Persaud D (2005) Long current impulses may be required for nerve stimulation in patients with ischemic pain. Can J Anaesth 52:963-966
  69. Auroy Y, Benhamou D, Bargues L et al. (2002) Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology 97:1274-1280
  70. Kehlet H (2000) Manipulation of the metabolic response in clinical practice. World J Surg 24:690-695
  71. Gimsa U, Schreiber U, Habel B et al. (2006) Matching geometry and stimulation parameters of electrodes for deep brain stimulation experiments--numerical considerations. J Neurosci Methods 150:212-227
  72. Wiesmann T, Bornträger A, Vassiliou T et al. (2014) Minimal current intensity to elicit an evoked motor response cannot discern between needle-nerve contact and intraneural needle insertion. Anesth Analg 118:681-686 ! 82!
  73. Rattay F, Aberham M (1993) Modeling axon membranes for functional electrical stimulation. IEEE Trans Biomed Eng 40:1201-1209
  74. Choquet O, Jochum D, Estebe JP et al. (2003) Motor response following paresthesia during interscalene block: methodological problems may lead to inappropriate conclusions. Anesthesiology 98:587-588 ! 72! 47. Choyce A, Chan VW, Middleton WJ et al. (2001) What is the relationship between paresthesia and nerve stimulation for axillary brachial plexus block? Reg Anesth Pain Med 26:100-104
  75. Steinfeldt T, Wiesmann T (2015) Needle-nerve proximity during peripheral nerve blocks--where is the right target and how can we get there? Rev Esp Anestesiol Reanim 62:121-124
  76. Greenblatt GM, Denson JS (1962) Needle nerve stimulatorlocator: nerve blocks with a new instrument for locating nerves. Anesth Analg 41:599-602
  77. Chin KJ, Perlas A, Chan VW et al. (2008) Needle visualization in ultrasound- guided regional anesthesia: challenges and solutions. Reg Anesth Pain Med 33:532-544
  78. Pearson RB (1955) Nerve block in rehabilitation: a technic of needle localization. Arch Phys Med Rehabil 36:631-633
  79. Cheney FW, Domino KB, Caplan RA et al. (1999) Nerve injury associated with anesthesia: a closed claims analysis. Anesthesiology 90:1062-1069
  80. Borgeat A, Ekatodramis G (2001) Nerve injury associated with regional anesthesia. Curr Top Med Chem 1:199-203
  81. Steinfeldt T, Nimphius W, Werner T et al. (2010) Nerve injury by needle nerve perforation in regional anaesthesia: does size matter? Br J Anaesth 104:245- 253
  82. Steinfeldt T (2012) Nerve injury due to peripheral nerve blocks: Pathophysiology and aetiology. Anasthesiol Intensivmed Notfallmed Schmerzther 47:328-333
  83. Steinfeldt T, Schwemmer U, Volk T et al. (2014) Nerve localization for peripheral regional anesthesia. Recommendations of the German Society of Anaesthesiology and Intensive Care Medicine. Anaesthesist 63:597-602
  84. Chan VW (2002) Nerve localization--seek but not so easy to find? Reg Anesth Pain Med 27:245-248
  85. Steinfeldt T, Nimphius W, Wurps M et al. (2010) Nerve perforation with pencil point or short bevelled needles: histological outcome. Acta Anaesthesiol Scand 54:993-999
  86. Gribomont B (1989) Nerve stimulation in locoregional anesthesia: Does it make a difference? Acta anaesthesiol belg 78. Grill WM (1999) Modeling the effects of electric fields on nerve fibers: influence of tissue electrical properties. IEEE Trans Biomed Eng 46:918-928
  87. De Andrés J, Alonso-Iñigo JM, Sala-Blanch X et al. (2005) Nerve stimulation in regional anesthesia: theory and practice. Best Pract Res Clin Anaesthesiol 19:153-174
  88. Fanelli G, Casati A, Garancini P et al. (1999) Nerve stimulator and multiple injection technique for upper and lower limb blockade: failure rate, patient acceptance, and neurologic complications. Study Group on Regional Anesthesia. Anesth Analg 88:847-852
  89. Barthram CN (1997) Nerve stimulators for nerve location--are they all the same? A study of stimulator performance. Anaesthesia 52:761-764
  90. Hadzic A, Vloka J, Hadzic N et al. (2003) Nerve stimulators used for peripheral nerve blocks vary in their electrical characteristics. Anesthesiology 98:969-974
  91. Trepel M (2011) Neuroanatomie: Struktur und Funktion. Urban und Fischer Verlag/Elsevier GmbH
  92. Fredrickson MJ, Kilfoyle DH (2009) Neurological complication analysis of 1000 ultrasound guided peripheral nerve blocks for elective orthopaedic surgery: a prospective study. Anaesthesia 64:836-844
  93. Brull R, McCartney CJ, Chan VW et al. (2007) Neurological complications after regional anesthesia: contemporary estimates of risk. Anesth Analg 104:965-974 ! 71! 31. Brull R, Perlas A, Chan VW (2007) Ultrasound-guided peripheral nerve blockade. Curr Pain Headache Rep 11:25-32
  94. Borgeat A (2005) Neurologic deficit after peripheral nerve block: what to do? Minerva Anestesiol 71:353-355
  95. Candido KD, Sukhani R, Doty R et al. (2005) Neurologic sequelae after interscalene brachial plexus block for shoulder/upper arm surgery: the association of patient, anesthetic, and surgical factors to the incidence and clinical course. Anesth Analg 100:1489-1495
  96. Myers RR, Kalichman MW, Reisner LS et al. (1986) Neurotoxicity of local anesthetics: altered perineurial permeability, edema, and nerve fiber injury. Anesthesiology 64:29-35
  97. Gadsden JC, Choi JJ, Lin E et al. (2014) Opening injection pressure consistently detects needle-nerve contact during ultrasound-guided interscalene brachial plexus block. Anesthesiology 120:1246-1253
  98. Casati A, Chelly JE, Lang SA et al. (2003) Paresthesia but no motor response: what's going on? Anesthesiology 98:586
  99. Selander D, Edshage S, Wolff T (1979) Paresthesiae or no paresthesiae? Nerve lesions after axillary blocks. Acta Anaesthesiol Scand 23:27-33
  100. Kalichman MW, Powell HC, Myers RR (1988) Pathology of local anesthetic- induced nerve injury. Acta Neuropathol 75:583-589
  101. Borgeat A, Schäppi B, Biasca N et al. (1997) Patient-controlled analgesia after major shoulder surgery: patient-controlled interscalene analgesia versus patient-controlled analgesia. Anesthesiology 87:1343-1347
  102. Hove LD, Nielsen HB, Christoffersen JK et al. (2006) Patient injuries in response to anaesthetic procedures: cases evaluated by the Danish Patient Insurance Association. Acta Anaesthesiol Scand 50:530-535
  103. Cooper K, Kelley H, Carrithers J (1995) Perceptions of side effects following axillary block used for outpatient surgery. Reg Anesth 20:212-216
  104. Scholz T, Pharaon M, Evans GR (2010) Peripheral nerve anatomy for regeneration studies in pigs: feasibility of large animal models. Ann Plast Surg 65:43-47
  105. Evans H, Steele SM, Nielsen KC et al. (2005) Peripheral nerve blocks and continuous catheter techniques. Anesthesiol Clin North America 23:141-162
  106. Klein SM, Evans H, Nielsen KC et al. (2005) Peripheral nerve block techniques for ambulatory surgery. Anesth Analg 101:1663-1676
  107. Selander D (1993) Peripheral nerve injury caused by injection needles. Br J Anaesth 71:323-325
  108. Rice AS, McMahon SB (1992) Peripheral nerve injury caused by injection needles used in regional anaesthesia: influence of bevel configuration, studied in a rat model. Br J Anaesth 69:433-438
  109. Selander D, Dhunér KG, Lundborg G (1977) Peripheral nerve injury due to injection needles used for regional anesthesia. An experimental study of the acute effects of needle point trauma. Acta Anaesthesiol Scand 21:182-188
  110. Klein SM, Melton MS, Grill WM et al. (2012) Peripheral nerve stimulation in regional anesthesia. Reg Anesth Pain Med 37:383-392
  111. De Andrés J, Sala-Blanch X (2001) Peripheral nerve stimulation in the practice of brachial plexus anesthesia: a review. Reg Anesth Pain Med 26:478-483
  112. Sharma AK, Thomas PK (1974) Peripheral nerve structure and function in experimental diabetes. J Neurol Sci 23:1-15
  113. Gentili ME, Wargnier JP, Caillon FC (1990) Peripheral neurologic complications of brachial plexus blocks. Cah Anesthesiol 38:561-567
  114. Kessler P, Steinfeldt T, Gogarten W et al. (2013) Peripheral regional anesthesia in patients under general anesthesia: risk assessment with respect to parasthesia, injection pain and nerve damage. Anaesthesist 62:483-488
  115. Kalichman MW (1993) Physiologic mechanisms by which local anesthetics may cause injury to nerve and spinal cord. Reg Anesth 18:448-452
  116. Kaiser H, Niesel HC, Klimpel L et al. (1992) Prilocaine in lumbosacral plexus block--general efficacy and comparison of nerve stimulation amplitude. Acta Anaesthesiol Scand 36:692-697
  117. Kalichman MW, Powell HC, Myers RR (1989) Quantitative histologic analysis of local anesthetic-induced injury to rat sciatic nerve. J Pharmacol Exp Ther 250:406-413
  118. Coriat P (1998) Reducing cardiovascular risk in patients undergoing non- cardiac surgery. Curr Opin Anaesthesiol 11:311-314
  119. Bernards CM, Hadzic A, Suresh S et al. (2008) Regional anesthesia in anesthetized or heavily sedated patients. Reg Anesth Pain Med 33:449-460
  120. Borgeat A (2006) Regional anesthesia, intraneural injection, and nerve injury: beyond the epineurium. Anesthesiology 105:647-648
  121. Chapman GM (1972) Regional nerve block with the aid of a nerve stimulator. Anaesthesia 27:185-193
  122. Bollini CA, Urmey WF, Vascello L et al. (2003) Relationship between evoked motor response and sensory paresthesia in interscalene brachial plexus block. Reg Anesth Pain Med 28:384-388
  123. Kalichman MW, Moorhouse DF, Powell HC et al. (1993) Relative neural toxicity of local anesthetics. J Neuropathol Exp Neurol 52:234-240
  124. Auroy Y, Narchi P, Messiah A et al. (1997) Serious complications related to regional anesthesia: results of a prospective survey in France. Anesthesiology 87:479-486
  125. Voelckel WG, Klima G, Krismer AC et al. (2005) Signs of inflammation after sciatic nerve block in pigs. Anesth Analg 101:1844-1846
  126. Fredrickson MJ, Ball CM, Dalgleish AJ (2008) Successful continuous interscalene analgesia for ambulatory shoulder surgery in a private practice setting. Reg Anesth Pain Med 33:122-128
  127. Bouaziz H, Mercier FJ, Narchi P et al. (1997) Survey of regional anesthetic practice among French residents at time of certification. Reg Anesth 22:218- 222
  128. Grau T, Fatehi S, Motsch J et al. (2004) Survey on current practice of regional anaesthesia in Germany, Austria, and Switzerland. Part 2: Use, success rates and techniques. Anaesthesist 53:847-855
  129. Bartusseck E, Fatehi S, Motsch J et al. (2004) Survey on practice of regional anaesthesia in Germany, Austria, and Switzerland. Part 1: Quality assurance and training concepts. Anaesthesist 53:836-846
  130. Steinfeldt T, Graf J, Vassiliou T et al. (2010) Systematic evaluation of the highest current threshold for regional anaesthesia in a porcine model. Acta Anaesthesiol Scand 54:770-776
  131. Kerr AT (1918) The brachial plexus of nerves in man, the variations in its formation and branches. Am J Anat:285-395
  132. Duncan CM, Hall Long K, Warner DO et al. (2009) The economic implications of a multimodal analgesic regimen for patients undergoing major orthopedic surgery: a comparative study of direct costs. Reg Anesth Pain Med 34:301-307
  133. Ercole A (2008) The effect of injectate conductivity on the electric field with the nerve stimulator needle: a computer simulation. Anesth Analg 107:1427-1432
  134. Kaiser H, Niesel HC, Hans V et al. (1990) The function of peripheral nerve stimulators in the implementation of nerve and plexus blocks. Reg Anaesth 13:172-178
  135. Stan TC, Krantz MA, Solomon DL et al. (1995) The incidence of neurovascular complications following axillary brachial plexus block using a transarterial approach. A prospective study of 1,000 consecutive patients. Reg Anesth 20:486-492
  136. Albrecht E, Kirkham KR, Taffé P et al. (2014) The maximum effective needle-to- nerve distance for ultrasound-guided interscalene block: an exploratory study. Reg Anesth Pain Med 39:56-60
  137. Horlocker TT, Kufner RP, Bishop AT et al. (1999) The risk of persistent paresthesia is not increased with repeated axillary block. Anesth Analg 88:382- 387
  138. Fredrickson MJ (2008) The sensitivity of motor response to needle nerve stimulation during ultrasound guided interscalene catheter placement. Reg Anesth Pain Med 33:291-296
  139. Perlas A, Niazi A, McCartney C et al. (2006) The sensitivity of motor response to nerve stimulation and paresthesia for nerve localization as evaluated by ultrasound. Reg Anesth Pain Med 31:445-450
  140. Geddes LA, Baker LE (1967) The specific resistance of biological material--a compendium of data for the biomedical engineer and physiologist. Med Biol Eng 5:271-293
  141. Franco CD, Domashevich V, Voronov G et al. (2004) The supraclavicular block with a nerve stimulator: to decrease or not to decrease, that is the question. Anesth Analg 98:1167-1171 ! 73! 63. Franco CD, Vieira ZE (2000) 1,001 subclavian perivascular brachial plexus blocks: success with a nerve stimulator. Reg Anesth Pain Med 25:41-46
  142. Pither C (1985) The use of peripheral nerve stimulators for regional anesthesia: a review of experimental characteristics, technique and clinical applications. Reg Anaesth.
  143. Koons RA (1969) The use of the Block-Aid Monitor and plastic intravenous cannulas for nerve blocks. Anesthesiology 31:290-291
  144. Eipe N, Padhi NR (2005) Tourniquet palsy or residual block? Anesth Analg 100:903-904
  145. Altermatt FR, Cummings TJ, Auten KM et al. (2010) Ultrasonographic appearance of intraneural injections in the porcine model. Reg Anesth Pain Med 35:203-206
  146. Saranteas T, Chantzi C, Iatrou C et al. (2007) Ultrasound and regional anesthesia techniques--is there any limitation? Reg Anesth Pain Med 32:546- 547
  147. Sauter AR, Dodgson MS, Stubhaug A et al. (2007) Ultrasound controlled nerve stimulation in the elbow region: high currents and short distances needed to obtain motor responses. Acta Anaesthesiol Scand 51:942-948
  148. Sites BD, Brull R (2006) Ultrasound guidance in peripheral regional anesthesia: philosophy, evidence-based medicine, and techniques. Curr Opin Anaesthesiol 19:630-639 ! 80!
  149. Sinha SK, Abrams JH, Weller RS (2007) Ultrasound-guided interscalene needle placement produces successful anesthesia regardless of motor stimulation above or below 0.5 mA. Anesth Analg 105:848-852
  150. Sites BD, Gallagher J, Sparks M (2003) Ultrasound-guided popliteal block demonstrates an atypical motor response to nerve stimulation in 2 patients with diabetes mellitus. Reg Anesth Pain Med 28:479-482
  151. Neal JM (2010) Ultrasound-guided regional anesthesia and patient safety: An evidence-based analysis. Reg Anesth Pain Med 35:S59-67
  152. Mulroy MF, Mitchell B (2002) Unsolicited paresthesias with nerve stimulator: case reports of four patients. Anesth Analg 95:762-763
  153. Beach ML, Sites BD, Gallagher JD (2006) Use of a nerve stimulator does not improve the efficacy of ultrasound-guided supraclavicular nerve blocks. J Clin Anesth 18:580-584 ! 70! 15. Benumof JL (2000) Permanent loss of cervical spinal cord function associated with interscalene block performed under general anesthesia. Anesthesiology 93:1541-1544
  154. Raj P (1980) Use of the nerve stimulator for peripheral blocks. Reg Anaesth.
  155. B. Braun AG, Deutschland (2009) User Manual Nerve Stimulator HSN 12. pp 14, 16, 50
  156. Urmey WF (2006) Using the nerve stimulator for peripheral or plexus nerve blocks. Minerva Anestesiol 72:467-471
  157. Jones RP, De Jonge M, Smith BE (1992) Voltage fields surrounding needles used in regional anaesthesia. Br J Anaesth 68:515-518
  158. Rattay F (1987) Ways to approximate current-distance relations for electrically stimulated fibers. J Theor Biol 125:339-349
  159. Carter C, Sandberg W (2003) What happened to the paresthesia? Anesthesiology 98:588
  160. Geddes LA, Bourland JD (1985) The strength-duration curve. IEEE Trans Biomed Eng 32:458-459
  161. Winnie AP (1970) Interscalene brachial plexus block. Anesth Analg 49:455-466
  162. Rushton WA (1951) A theory of the effects of fibre size in medullated nerve. J Physiol 115:101-122 ! 79!
  163. Jack NT, Liem EB, Vonhögen LH (2005) Use of a stimulating catheter for total knee replacement surgery: preliminary results. Br J Anaesth 95:250-254
  164. Butson CR, McIntyre CC (2006) Role of electrode design on the volume of tissue activated during deep brain stimulation. J Neural Eng 3:1-8
  165. Bonica JJ, Moore DC (1950) Brachial plexus block anesthesia. Curr Res Anesth Analg 29:241-253
  166. Rigaud M, Filip P, Lirk P et al. (2008) Guidance of block needle insertion by electrical nerve stimulation: a pilot study of the resulting distribution of injected solution in dogs. Anesthesiology 109:473-478
  167. Tai C, Roppolo JR, de Groat WC (2009) Analysis of nerve conduction block induced by direct current. J Comput Neurosci 27:201-210
  168. Neal JM, Bernards CM, Hadzic A et al. (2008) ASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine. Reg Anesth Pain Med 33:404-415
  169. Hogan QH (2008) Pathophysiology of peripheral nerve injury during regional anesthesia. Reg Anesth Pain Med 33:435-441
  170. Steinfeldt T, Graf J, Schneider J et al. (2011) Histological Consequences of Needle-Nerve Contact following Nerve Stimulation in a Pig Model. Anesthesiol Res Pract 2011:591851
  171. Birnbaum J, Klotz E, Bogusch G et al. (2007) Electrical nerve stimulation for plexus and nerve blocks. Anaesthesist 56:1155-1162
  172. Holsheimer J, Dijkstra EA, Demeulemeester H et al. (2000) Chronaxie calculated from current-duration and voltage-duration data. J Neurosci Methods 97:45-50


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