Safety and efficacy of the infraclavicular nerve block performed at low current.
It has recently been suggested that peripheral nerve or plexus blocks performed with the use of a nerve stimulator at low currents (<0.5 mA) may result in neurologic damage. We studied the infraclavicular nerve block, performed with the use of a nerve stimulator and an insulated needle, in a prospective evaluation of efficacy and safety. During a one-year period, 248 patients undergoing infraclavicular nerve block were evaluated for block success rate and incidence of neurologic complication. All blocks were performed with the use of a nerve stimulator and an insulated needle at < or =0.3 mA. Success rate was 94%, which increased to 96% with surgical infiltration of local anesthetic. There were no intraoperative or immediate postoperative complications noted. After one week, only one patient had a neurologic complaint, and this was surgically related, referable to surgery performed on the radial nerve. We conclude that infraclavicular nerve blocks performed at low currents (< or =0.3 mA) are safe and effective.
Keschner
Mitchell T
MT
Department of Anesthesiology, NYU Hospital for Joint Diseases, New York 10003, USA.
Michelsen
Heidi
H
Rosenberg
Andrew D
AD
Wambold
Daniel
D
Albert
David B
DB
Altman
Robert
R
Green
Steven
S
Posner
Martin
M
D000779:Anesthetics, Local / Q000008:administration & dosage; D001132:Arm / Q000294:innervation / Q000601:surgery; D001917:Brachial Plexus / Q000033:anatomy & histology* / Q000502:physiology / Q000601:surgery*; D002968:Clavicle / Q000033:anatomy & histology* / Q000294:innervation; D004558:Electric Stimulation / Q000295:instrumentation / Q000379:methods; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D009407:Nerve Block / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D009431:Neural Conduction / Q000502:physiology; D010525:Peripheral Nerves / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011446:Prospective Studies; D016896:Treatment Outcome
D000779:Anesthetics, Local