Lokalisation peripherer Nerven

Abstract

Peripheral electrical nerve stimulation is one of the standard applications in peripheral regional anesthesia in addition to the ultrasound technique. Among other findings, the visualization of needle and nerve during ultrasound-guided blockade caused a change in clinical practice of peripheral nerve stimulation in the last decade. In the present article old and new aspects of principles and clinical practice of the nerve stimulation technique are presented and summarized in a total clinical concept in order to achieve safe and successful peripheral regional anesthesia using electrical peripheral nerve stimulation.

Blockade of the distal sciatic nerve with the patient in the supine position using a newly developed position aid with integrated ultrasound probe holder

“…For several reasons our femoral supporting pad with the integrated ultrasound probe holder is a substantial improvement compared to the techniques used currently. First, compared to the various described techniques [6][7][8][9][10], which are used for the blockade of the distal sciatic nerve, the patient can remain in supine position, while the femoral supporting pad is placed under the thigh and shifted along the length axis until an optimal visualization of the distal sciatic nerve has been achieved. Second, with our integrated ultrasound probe holder a continuous visualization of the needle and its tip on its way to the nerve is possible.…”

“…Ultrasound guided blockade of the distal sciatic nerve is a standard technique to provide intra-neural and postoperative analgesia for lower limb and knee surgery [1][2][3][4]. While ultrasound guidance might avoid intra-neural injection [5], the various techniques (anterior medial adductor canal approach, distal medial or lateral approach) are time consuming in their realization and might be awkward, when using ultrasound guidance, because of the need of special positioning of the patient or its leg [6][7][8][9][10][11]. Accordingly we have developed a novel femoral supporting pad with an integrated ultrasound probe holder to easily perform ultrasound guided distal sciatic nerve blockade while the patient remaining in the supine position.…”