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Related Experiment Videos

Locating the target nerve and injectate spread in rabbit sciatic nerve block.

Duk Hyun Sung1

  • 1Department of Physical Medicine and Rehabilitation, Sungkyunkwan University School of Medicine, Samsung Medical Center, #50 Irwon-Dong, Gangnam-Gu, Seoul 136-710, Korea. dhsung@smc.samsung.co.kr

Regional Anesthesia and Pain Medicine
|May 13, 2004
PubMed
Summary

Nerve stimulators accurately locate target nerves within 5 mm, requiring minimal current. Injectate spreads over 20 mm, even with small volumes, in percutaneous nerve blocks.

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Area of Science:

  • Anesthesiology
  • Neuroscience
  • Surgical Techniques

Background:

  • Percutaneous nerve blocks are crucial for regional anesthesia and pain management.
  • Precise needle placement and understanding injectate spread are vital for efficacy and safety.
  • Nerve stimulators are commonly used to guide needle placement during these procedures.

Purpose of the Study:

  • To determine the accuracy of needle tip placement relative to the target nerve using a nerve stimulator.
  • To quantify the spread of injectate in percutaneous nerve blocks.

Main Methods:

  • Sciatic nerves in New Zealand white rabbits were located using a 2-dimensional needle manipulator and nerve stimulator.
  • Stimulation current thresholds for motor responses were measured at various needle insertion depths.

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  • The nerve-needle distance was recorded at the point of minimum stimulation current.
  • Injectate spread was visualized using Indian ink and phenol in a separate cohort of rabbits.

    • Main Results:

    • The target nerve was consistently located within 5 mm of the needle tip with less than 0.5 mA stimulation current.
    • Needle placement accuracy was within 1.1 mm (absolute value) in Group I and 2.2 mm in Group II.
    • Injectate (100 microL) spread longitudinally over 25 mm within the perineural tissue.
    • Axonal degeneration correlated with the pattern of injectate spread.

    Conclusions:

    • Nerve stimulators provide accurate guidance for needle placement in percutaneous nerve blocks.
    • A small volume of injectate can spread extensively along the nerve, influencing the block's extent.
    • These findings have implications for optimizing nerve block techniques and predicting outcomes.