2013•Shanghai yixueRequires access
Application of percutaneous nerve stimulation pen combined with nerve stimulator in axillary brachial plexus block
Xiong Zhaodon
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Abstract
Objective To evaluate the application of percutaneous nerve stimulation pen combined with nerve stimulator in axillary brachial plexus block by localizing musculocutaneous nerve,radial nerve,median nerve and ulnar nerve.Methods Forty patients undergoing forearm or hand surgery were randomly divided into study group and control group(n=20).In the study group,we performed nerve localization and block by percutaneous nerve stimulation pen first,then by nerve stimulator.In the control group,only nerve stimulator was used.Axillary brachial plexus block was performed by multi-injection technique in both groups.Musculocutaneous nerve,radial nerve,median nerve and ulnar nerve were localized in turn,and 0.375% ropivacaine 10mL were injected in each neurostimulation point.Nerve localization(achievement ratio,operation time,puncture depth and time),sensory and motor nerve block duration,and complications such as vascular and nerve injury were assessed.Results Surgical operation was conducted smoothly in all patients and no adjuvant drug was used.The achievement ratio of nerve block was 100% in both groups.There were no significant differences in terms of total operation time, achievement ratio of each nerve localization,needle puncture depth,the time of sensory and motor nerve block,or the puncture time of ulnar nerve between two groups(all P0.05).But the puncture time of musculocutaneous nerve,radial nerve and median nerve in the study group were significantly shorter than those in the control group(P0.01,0.05).Vascular injury occurred in 1 case in the study group and in 3 cases in the control group;no other complications such as nerve damage occurred in both groups.There was no significant difference in the incidence of complications between two groups(all P0.05).Conclusion With the help of percutaneous nerve stimulation pen,the puncture time of musculocutaneous nerves,radial nerve and median nerve can be significantly shortened.