Ultrasound Guidance With Nerve Stimulation Reduces the Time Necessary for Resident Peripheral Nerve Blockade

Abstract

During resident teaching, ultrasound-aided peripheral nerve-stimulated block required less time to perform than did nerve-stimulator-guided blocks. Fewer needle insertions were required to perform the ultrasound-guided blocks, and there were fewer blood vessel punctures when ultrasound was used.

Factors impacting on-time transfer to the operating room in patients undergoing peripheral nerve blocks in the preoperative area

“…Orebaugh et al reported recently that the time to perform the blocks varies between 1.8 minutes (ultrasound-guided techniques) and 6.5 minutes (neurostimulation) [15]. These times were shorter than those reported in our study and most likely have less influence on on-time transfer to the OR.…”

A prospective analysis of interscalene brachial plexus blocks performed under general anesthesia

“…1,2,8,9,[11][12][13][14][17][18][19]21,25,27,28,30,[35][36][37][41][42][43]45 The lists include phrenic nerve block, recurrent laryngeal nerve block, brachial plexus palsy/neuritis, Horner's syndrome, bronchospasm, spinal blockade, and cardiac arrest. The most common side effect noted in prior reports is ipsilateral phrenic nerve block, which may occur in up to 100% of patients.…”

“…3,7,34,44 Reported complications of interscalene anesthesia include: seizure, cardiovascular collapse, pneumothorax, intraneural injection, spinal cord injection, brachial plexitis, auditory disturbance, dyspnea secondary to phrenic nerve palsy, chronic Horner's syndrome, pseudo aneurysm, and permanent paresthesias. 1,2,8,9,[11][12][13][14][17][18][19]21,[26][27][28]30,[35][36][37][41][42][43]45 In some anecdotal case reports, authors have expressed a concern that there would likely be an increased risk of serious complications if the procedure were to be performed after induction of general anesthesia. 3,34 However, we are not aware of any study which actually documents increased complications associated with interscalene anesthesia performed after induction of general anesthesia or compares complications in nonanesthetized patients versus those under general anesthesia.…”

Role of local anesthetic spread pattern and electrical stimulation in ultrasound-guided musculocutaneous nerve block

“…Despite the growing popularity of ultrasound-guided regional anesthesia techniques, many centers still commonly use electrical stimulation for teaching purposes [8] or because of the high cost of ultrasound machines. However, Chan et al [9] reported that ultrasound guidance improved the success rate of axillary brachial plexus block, with or without electrical stimulation.…”