Electrical impedance to distinguish intraneural from extraneural needle placement in porcine nerves during direct exposure and ultrasound guidance

Anesthesiology
Ban C H TsuiDerek Dillane

Abstract

Intraneural injection during peripheral nerve blockade can cause neurologic injury. Current approaches to prevent or detect intraneural injection lack reliability and consistency, or only signal intraneural injection upon the event. A change in electrical impedance (EI) could be indicative of intraneural needle placement before injection. After animal care committee approval, eight pigs were anesthetized and kept spontaneously breathing. In four pigs (part 1), the sciatic nerves were exposed bilaterally for direct needle placement; in a further four pigs (part 2), the tissue was kept intact for ultrasound-guided needle placement. An insulated needle (Sprotte 24 gauge; Pajunk GmbH Medizintechnologie, Geisingen, Germany), attached to a nerve stimulator displaying EI (Braun Stimuplex HNS 12; B. Braun Medical, Bethlehem, PA), was placed extraneurally and then advanced to puncture the nerve sheath. Five punctures within approximately a 1-cm length of each nerve were performed. For each Part, overall EI at each compartment and EI after individual punctures were compared using a general linear model, with post hoc analysis using the Duncan multiple range test. The EI was lower extraneurally compared with intraneurally during open diss...Continue Reading

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Citations

Nov 16, 2011·Der Anaesthesist·M Neuburger, J Büttner
Mar 12, 2010·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·James Chin, Ban C H Tsui
Nov 30, 2012·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Patrick BardouPierre Beaulieu
Jul 1, 2010·Regional Anesthesia and Pain Medicine·Joseph M Neal, Denise J Wedel
Apr 15, 2011·Regional Anesthesia and Pain Medicine·Alan James Robert MacfarlaneRichard Brull
Oct 1, 2011·International Anesthesiology Clinics·Kelly Byrne, Ban C H Tsui
Feb 15, 2014·BMC Anesthesiology·Hubert J SchmittTino Münster
Feb 22, 2014·Anesthesia and Analgesia·Faraj W Abdallah, Vincent W S Chan
Jul 24, 2014·Der Anaesthesist·T SteinfeldtUNKNOWN German Society of Anaesthesiology and Intensive Care Medicine
Jun 25, 2009·Current Opinion in Anaesthesiology·Oivind KlaastadMichael S Dodgson
Aug 7, 2010·Current Opinion in Anaesthesiology·Derek Dillane, Ban C H Tsui
Jan 26, 2016·Acta Anaesthesiologica Scandinavica·A R Sauter, L Romundstad
Nov 5, 2011·Paediatric Anaesthesia·Derek Dillane, Ban C H Tsui
May 23, 2015·Acta Anaesthesiologica Scandinavica·L HelenE Moore
May 15, 2015·Regional Anesthesia and Pain Medicine·Richard BrullMichael J Barrington
Sep 4, 2015·Journal of Anaesthesiology, Clinical Pharmacology·Herman SehmbiKi Jinn Chin
Apr 24, 2015·Journal of Clinical Monitoring and Computing·Håvard Kalvøy, Axel R Sauter
Feb 25, 2010·Anesthesiology·Alain BorgeatArmin Curt
Jan 10, 2017·Anesthesia and Analgesia·Rakesh V Sondekoppam, Ban C H Tsui
Jun 12, 2012·Regional Anesthesia and Pain Medicine·Stephen M KleinKaren C Nielsen
Jan 12, 2021·Anaesthesia·G A McLeod
Feb 23, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Chiyo OotakiYuki Koyama
Jun 18, 2021·Journal of Pain Research·Zehao Wu, Yun Wang

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