Key result
Use of a peripheral nerve stimulator showed no significant difference in the number of needle insertions or success rate compared to reliance on paraesthesiae.
Why the study?
Does a peripheral nerve stimulator improve success rate or reduce needle insertions compared to reliance on paraesthesiae in regional analgesia?
RCT (n=60)
Equally but randomly divided
Does a peripheral nerve stimulator improve success rate or reduce needle insertions compared to reliance on paraesthesiae in regional analgesia?
A peripheral nerve stimulator does not significantly improve success rates or reduce needle insertions compared to eliciting paraesthesia during regional blocks, except in patients unable to cooperate.
Nerve stimulators confer no advantage over paraesthesia guidance; challenges routine use and supports simpler technique in cooperative patients.
Forty interscalene brachial plexus regional blocks and twenty sciatic-femoral lower limb blocks were performed by 1st and 2nd year anaesthesia residents. Nerve trunk location was equally but randomly divided between use of a peripheral nerve stimulator and reliance on paraesthesiae. The stimulator group were sedated prior to nerve block while the non-stimulator group were similarly sedated after nerve block. There was no significant difference either in the number of needle insertions required for nerve location, or in the success rate, between stimulator and non-stimulator techniques. It is concluded that the stimulator is not a useful adjunct for nerve location, except in those patients who are unable to co-operate in eliciting paraesthesia. In such patients the stimulator permits a comparable success rate.
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Baird Smith (1976) conducted an RCT in Regional analgesia (n=60). Peripheral nerve stimulator vs. Reliance on paraesthesiae was evaluated on Number of needle insertions required for nerve location and success rate. Use of a peripheral nerve stimulator showed no significant difference in the number of needle insertions or success rate compared to reliance on paraesthesiae.
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