Nerve stimulation in regional anesthesia: theory and practice

Area of Science:

• Regional Anesthesia
• Neurostimulation
• Anesthesiology

Background:

• Extensive experience supports electrical stimulation for needle-nerve approximation in regional anesthesia.
• This technique has demonstrated benefits in teaching, performing difficult nerve blocks, and utilizing novel approaches.
• Electrical nerve stimulation offers advantages in uncooperative or sedated patients, though intraneural injection risk persists.

Purpose of the Study:

• To review key aspects of electrical nerve stimulation in plexus regional anesthesia.
• To update clinical applications based on accumulated experience and knowledge.
• To emphasize the integration of anatomical, physiological, and pharmacological principles with nerve stimulation.

Main Methods:

• Review of accumulated clinical experience and literature on electrical stimulation for nerve blocks.
• Discussion of anatomical considerations, neurophysiology, and local anesthetic pharmacology.
• Analysis of electrical needle features and devices used in nerve stimulation.

Main Results:

• Electrical stimulation verifies needle-nerve proximity, increasing regional anesthesia success rates.
• Application leads to decreased morbidity and reduced local anesthetic requirements.
• Effective in various patient populations, including uncooperative or sedated individuals.

Conclusions:

• Effective implementation of nerve stimulation requires a comprehensive understanding of anatomy, neurophysiology, and local anesthetic pharmacology.
• Electrical stimulation is a valuable tool for enhancing the safety and efficacy of plexus regional anesthesia.
• Updated knowledge and techniques improve the clinical application of nerve stimulation in practice.