The Concept of Protective Nerve Stimulation for Ultrasound Guided Nerve Blocks

Publication date: Available online 16 August 2017
Source:Medical Hypotheses
Author(s): Martin Ertmer, Edda Klotz, Jürgen Birnbaum
Regional plexus and nerve blocks are a common technique in modern anesthesia. Since ultrasound machines are available in many departments, the role of nerve stimulation is highly discussed and different approaches to perform the blocks are taken into account. Common technique for electrical nerve stimulation is searching for a stimulating threshold of 0.4 to 0.5 mA using an impulse width of 0.1 ms. We present our hypothesis of using all possible information with a new concept of protective nerve stimulation together with first data supporting our theory. In protective nerve stimulation during ultrasound guided nerve blocks a fixed current of 1.0 mA (0.1 ms) is used without any change during block performance. The aim is no muscular twitches before and during injection. If this way of neuro-axial blocking brings suitable effects, we should consider new currency settings to perform safer blockades with a lower risk of nerve injuries and a high patient comfort, especially in bad visibility block situations.



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