PMID: 15220786Jun 29, 2004Paper

Time sequence of sensory changes after upper extremity block: swelling sensation is an early and accurate predictor of success

Anesthesiology
X PaqueronBruno Riou

Abstract

Sensory assessment to estimate spread and effectiveness of a peripheral nerve block is difficult because no clinical test is specific for small sensory fibers. Occurrence of a swelling illusion (SI) during a peripheral nerve block corresponds to the impairment of small sensory fibers. The authors investigated the usefulness of SI in predicting successful peripheral nerve block by assessing the temporospatial correlation between progression of sensory impairment in cutaneous distributions anesthetized and localization of SI during peripheral nerve block installation. Interscalene, infracoracoid, or sciatic nerve blocks were performed using a nerve stimulator and 1.5% mepivacaine in 53 patients, with a total of 201 nerves to be anesthetized. Pinprick, cold, warm, touch, and proprioception were assessed every 3 min, while patients were asked to describe their perception of size and shape of their anesthetized limb and localization of these illusions. Data are presented as mean +/- SD and percentage (95% confidence interval). Failure occurred in 12 cutaneous distributions out of a total of 201 theoretically blocked nerves. SI appeared earlier than warmth impairment (4.3 +/- 2.7 vs. 6.2 +/- 2.0 min; P < 0.05), always corresponding t...Continue Reading

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Citations

Dec 24, 2005·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Pierre PandinArlette Vandesteene
May 16, 2006·Brain Research·Xin Wang, John T Wall
Feb 23, 2013·Current Biology : CB·Patrick HaggardMatthew R Longo
Jan 4, 2017·Anaesthesia·K OdeA F Smith
Feb 26, 2015·Neurorehabilitation and Neural Repair·Susan HillierDominic Thewlis
Jun 26, 2018·Acta Anaesthesiologica Scandinavica·H HermannsM F Stevens
Mar 20, 2015·Experimental Brain Research·Lee D WalshPatrick Haggard
Sep 9, 2017·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Asger M AndreasenLars H Lundstrøm

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