156 Evaluation of the peripheral nerve stimulator usage for a successful costaclavicular brachial plexus block

• Published in: Regional anesthesia and pain medicine Vol. 70; no. Suppl 1; p. A82
• Main Authors: Soylu, S, Şehirlioğlu, S, Genç Moralar, D, Türkmen, Ü Aygen
• Format: Journal Article
• Language: English
• Published: Secaucus BMJ Publishing Group Ltd 01-09-2021; BMJ Publishing Group LTD
• Subjects: Bone surgery; Brachial plexus; Peripheral nerve blocks; Regional anesthesia; Success; Ultrasonic imaging
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1136/rapm-2021-ESRA.156

Background and AimsUltrasound (US) has become standardized during peripheral nerve block (PNB). Peripheral nerve stimulator (PNS) is combined with US to avoid intraneural injection (1). Monitoring opening injection pressure with a sensor could also show intraneural injection (2). Adding PNS to US guidance did not change block success rates for different types of PNBs (3,4). There is no study in the literature that evaluate effectiveness of adding PNS to US for a successful costaclavicular brachial plexus block (CCBPB). In this randomized prospective clinical study US and injection pressure monitor (IPM) guided CCBPB is compared with US, IPM and PNS guided CCBPB.Methods60 patients scheduled for orthopedic surgery below the elbow were enrolled in the study. Ultrasound and IPM guided group called USP and US, IPM and PNS guided group called USPN. In both groups 30 ml bupivacaine-lidocaine mixture was injected when injection pressure is less than 15 psi. In Group USPN, local anesthetic was injected after visualizing the disappearance of motor movement under 0.3 mA on PNS. Motor and sensorial block levels of the radial, ulnar, median and musculocutaneous nerves were measured. Block success rate, block performance time, number of needle passes and complication rates were compared.ResultsBlock success rate, number of needle passes and complications were similar (table 1). Block performance time was longer in group USPN (figure 1).Abstract 156 Figure 1Abstract 156 Figure 2Abstract 156 Table 1ConclusionsPeripheral nerve stimulator is not necessary for a successful CCBPB. Using PNS increased block performance time significantly. Ultrasound and IPM are enough for a successful block with shorter procedure time in CCBPB.