title: Electric Nerve Stimulation Does Not Correctly Predict Needle-Nerve Distance and Potential Local Anesthetic Spread for Interscalene Brachial Plexus Blockade.
abstract: This study evaluated electric nerve stimulation as a nerve location tool. After eliciting motor response in 43 patients undergoing shoulder surgery, the needle tip's position, distance from the closest nerve, and spread of saline were evaluated using ultrasound imaging. The needle's tip resided 1 to 4 mm from the closest nerve in 21, in direct contact with it in 7, and 6 to 18 mm away in 15 patients. In 21 patients, subsequent saline dissection did not reach the brachial plexus. Thus, the success rate of electric nerve stimulation for correct needle-nerve distance identification was 48.8%, with correct fluid spread reached in only 51.2% of patients.
authors.affiliation: From the *Klinik für Anästhesiologie und Intensivmedizin; †Klinik für Orthopädie, Dietrich Bonhoeffer Klinikum Neubrandenburg, Neubrandenburg, Germany; and ‡Klinik für Anästhesiologie, Universitätsmedizin Greifswald, Greifswald, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fielmuth
authors.forename: Marek
authors.initials: M
authors.lastname: Szalata
authors.forename: Heidi
authors.initials: H
authors.lastname: Sievert
authors.forename: David
authors.initials: D
authors.lastname: Beier
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rehberg
authors.forename: Klaus
authors.initials: K
authors.lastname: Hahnenkamp
authors.forename: Knut
authors.initials: K
authors.lastname: Mauermann
authors.forename: Konrad
authors.initials: K
authors.lastname: Meissner
mesh_terms: D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001917:Brachial Plexus / Q000187:drug effects* / Q000502:physiology; D065527:Brachial Plexus Block / Q000379:methods*; D004558:Electric Stimulation; D006801:Humans; D009339:Needles; D009407:Nerve Block / Q000379:methods*; D015203:Reproducibility of Results; D012782:Shoulder / Q000601:surgery*; D014463:Ultrasonography
chemical_list: D000779:Anesthetics, Local