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Related Experiment Videos

Nerve stimulator polarity and brachial plexus block

A Tulchinsky1, R S Weller, M Rosenblum

  • 1Department of Anesthesiology, University of Connecticut School of Medicine, Farmington.

Anesthesia and Analgesia
|July 1, 1993
PubMed
Summary

Needle polarity is crucial for nerve stimulation during peripheral nerve blocks. Using the negative terminal of the nerve stimulator with the electrode ensures effective nerve localization and successful block placement.

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Area of Science:

  • Anesthesiology
  • Neurology
  • Surgical Procedures

Background:

  • Peripheral nerve blocks are essential for surgical anesthesia and analgesia.
  • Accurate nerve localization is critical for effective peripheral nerve blocks.
  • Nerve stimulator use is standard for guiding needle placement in peripheral nerve blocks.

Purpose of the Study:

  • To investigate the impact of needle polarity on nerve stimulation thresholds during peripheral nerve blocks.
  • To determine if positive or negative needle polarity influences the current required for muscle contraction.
  • To optimize nerve localization techniques in regional anesthesia.

Main Methods:

  • A randomized, double-blinded study involving 10 patients undergoing axillary block.
  • An insulated needle was used to assess minimum current for muscle contraction.

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  • Measurements were taken at initial and maximal stimulation points with both positive and negative needle polarity.

    • Main Results:

    • Significantly higher currents were needed for stimulation with positive needle polarity compared to negative polarity at both tested positions (P < 0.001).
    • The ratio of positive to negative threshold current was significantly greater at maximal stimulation point (3.11) than at initial stimulation point (2.37) (P < 0.05).
    • Positive needle polarity required substantially more current, potentially hindering accurate nerve identification.

    Conclusions:

    • Needle polarity significantly affects nerve stimulation thresholds during peripheral nerve blocks.
    • Attaching the negative terminal of the nerve stimulator to the stimulating electrode is vital for reliable nerve localization.
    • Incorrect polarity may lead to failed blocks or missed neural contacts, emphasizing the importance of correct electrode connection.