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

Journal of Clinical Anesthesia
Bassam Al-NasserMichèle Négre

Abstract

To evaluate local anesthetic spread on the frequency of success of musculocutaneous nerve block, and to determine needle-to-target-nerve distance by ultrasound imaging and electrical stimulation. Observational study. Private hospital. 48 ASA physical status I and II adults (16 men and 32 women) scheduled for elective carpal tunnel release or wrist ganglion cyst surgery in an outpatient setting. The musculocutaneous nerve (MCN) was identified by ultrasound. An insulated needle connected to an electrical stimulator in the "off" position was inserted in the biceps side of the probe in the plane of the ultrasound beam. The needle tip was placed in the vicinity of the MCN. Local anesthetic spread pattern was determined by ultrasound imaging. The lowest effective current intensity was registered. The average depth of the MCN was measured by ultrasound. In all patients, the local anesthetic solution spread was uneven. In 32% of patients (15/47), motor response was still elicited with electrical stimulation intensity lower or equal to 0.3 mA. In 26% of patients (12/47), motor response disappeared with electrical stimulation intensity higher or equal to 0.6 mA. In 42% of patients (20/47), motor response disappeared at intensities betwee...Continue Reading

References

May 13, 2004·Regional Anesthesia and Pain Medicine·Admir Hadzic
Mar 3, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Ban Tsui
Mar 3, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Vincent W S ChanSherif Abbas

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Citations

Apr 15, 2011·Regional Anesthesia and Pain Medicine·Richard BrullVincent W S Chan
Apr 15, 2011·Regional Anesthesia and Pain Medicine·Alan James Robert MacfarlaneRichard Brull
Jun 12, 2012·Regional Anesthesia and Pain Medicine·Stephen M KleinKaren C Nielsen
Jan 17, 2012·Current Opinion in Anaesthesiology·Zbigniew J Koscielniak-Nielsen, Jörgen B Dahl
Jul 24, 2012·Current Opinion in Anaesthesiology·Olivier ChoquetXavier Capdevila
Feb 28, 2014·British Journal of Anaesthesia·D MarhoferM Zeitlinger
Oct 12, 2010·Annales Françaises D'anesthèsie Et De Rèanimation·B Al Nasser

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