Ultrasound-guided block and the incidence of intraneural injection

Szerb, Jennifer; Kwofie, Kwesi

doi:10.1111/anae.13913

Cited by 3 publications

(2 citation statements)

References 6 publications

(13 reference statements)

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“…This incidence is consistent with other series investigating ultrasound-guided nerve techniques in the median nerve at the level of the forearm 14. The incidence of nerve swelling was high when compared with studies focusing on other nerve blocks 15–17. Differences in definition criteria and limited ultrasound resolution to distinguish different components of the nerve anatomy18 could explain this finding.…”

Section: Discussionsupporting

confidence: 87%

Comparison of the effectiveness of circumferential versus non-circumferential spread in median and ulnar nerve blocks. A double-blind randomized clinical trial

Dieguez-Garcia¹,

López-Álvarez

Juncal

et al. 2020

Reg Anesth Pain Med

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Background and objectivesCircumferential (C) spread of local anesthetic around the nerve is recommended for a successful nerve block. We tested the hypothesis that C spread produces a more complete block than non-circumferential (NC) spread.MethodsWe randomized 124 patients undergoing open carpal tunnel syndrome surgery to receive C or NC spread ultrasound-guided median and ulnar nerve blocks. The primary outcome was the proportion of patients who developed complete sensory block measured at 5, 15 and 30 min. The loss of cold sensation was graded as: 0 (complete block), 1 (incomplete block), or 2 (no block). Secondary outcomes included motor block, nerve swelling and adverse events.ResultsIn group C, complete sensory block at 5 min was 2.4 (95% CI 1.0 to 5.7; p=0.04) times more frequent in the median nerve and 3.0 (95% CI 1.2 to 7.2; p=0.01) times more frequent in the ulnar nerve compared with group C. However, at 15 and 30 min, it was similar between groups. Complete motor block was more frequent in group C than in group NC for both the median nerve: 1.5 (95% CI 1.1 to 2.2; p<0.01) at 15 min, 1.1 (95% CI 1.0 to 1.2; p=0.02) at 30 min, and the ulnar nerve: 1.7 (95% CI 1.2 to 2.6; p<0.01) at 15 min, 1.2 (95% CI 1.0 to 1.4; p<0.01) at 30 min. The incidence of nerve swelling and adverse effects was similar between groups.ConclusionsC spread around the median and ulnar nerves at the level of the antecubital fossa generates more complete sensory and motor blocks compared with NC spread.Trial registration numberEudraCT 2011-002608-34 and NCT01603680

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Section: Discussionsupporting

confidence: 87%

Comparison of the effectiveness of circumferential versus non-circumferential spread in median and ulnar nerve blocks. A double-blind randomized clinical trial

Dieguez-Garcia¹,

López-Álvarez

Juncal

et al. 2020

Reg Anesth Pain Med

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“…Other authors suggest the use of ultrasound to stay farer away from the nerval borders altogether 115 . We know that all local anesthetics can be neurotoxic to different degrees 116,117,118 . As this is a dose dependent effect, reducing concentration and volume -a proved advantage of USGRA -may reduce the risk of nerve damage.…”

Section: Further Ultrasound Related Approaches To Avoid Nerve Injurymentioning

confidence: 99%

Ultrasound guided regional anesthesia: What we know, what we think we know, what we don't know yet: Running title USGRA: Overview about facts and questions: An educational narrative review of literature

Huppertz-Thyssen,

Nikolić

2023

Serb J Anest Inten Therapy

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The introduction of ultrasound guidance over the last two decades brought progress, new blocks and new challenges to Regional Anesthesia. This narrative review addresses and discusses facts, frequent questions, beliefs, controversies, unsolved issues, open safety questions and existing knowledge gaps related to efficacy and safety of ultrasound guided regional anesthesia (USGRA), based on the available literature. We discuss evidence-based advantages and limitations of ultrasound guidance, as well as unresolved questions, with respect to successful anesthesia, undesired side effects and patient safety, like nerve injury and local anesthetic systemic toxicity (LAST). In an educational approach we also emphasize some practical aspects of our everyday experience as well as necessary structural requirements.

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Effects of Stellate Ganglion Block on Analgesia Produced by Cervical Paravertebral Block as Established by Quantitative Sensory Testing: A Randomized Controlled Trial

et al. 2018

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Ultrasound-guided block and the incidence of intraneural injection

Cited by 3 publications

References 6 publications

Comparison of the effectiveness of circumferential versus non-circumferential spread in median and ulnar nerve blocks. A double-blind randomized clinical trial

Comparison of the effectiveness of circumferential versus non-circumferential spread in median and ulnar nerve blocks. A double-blind randomized clinical trial

Ultrasound guided regional anesthesia: What we know, what we think we know, what we don't know yet: Running title USGRA: Overview about facts and questions: An educational narrative review of literature

Effects of Stellate Ganglion Block on Analgesia Produced by Cervical Paravertebral Block as Established by Quantitative Sensory Testing: A Randomized Controlled Trial

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