Locating the target nerve and injectate spread in rabbit sciatic nerve block

被引:27
作者
Sung, DH [1 ]
机构
[1] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Phys Med & Rehabil, Seoul 1325710, South Korea
关键词
nerve block; neurolysis; nerve stimulator; peripheral nerve;
D O I
10.1016/j.rapm.2003.12.003
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background and Objectives: The purpose of this study is to determine how close the needle tip is placed to the target nerve using a nerve stimulator and to determine how far the injectate spreads in percutaneous nerve blocks. Methods: Twenty-four sciatic nerves of New Zealand white rabbits were located with a 2-dimensional needle manipulator and a nerve stimulator (pulse width: 100 mus for group 1, 250 mus for group II). The stimulation current required to elicit a motor response for each insertion depth of the needle and the nerve-needle distance at which the required current reached the minimum were measured. Another 10 sciatic nerves were located manually using a nerve stimulator and neurolyzed with a mixed solution of 5% phenol and Indian ink (100 p,L). Results: The nerve-needle distance was in the range of -1.2 mm to +2.8 mm in group I (1.1 +/- 0.9 mm [mean standard error] in absolute value) and -0.2 mm to +4.8 mm (2.2 +/- 1.7 mm [mean standard error] in absolute value) in group 11 (positive values signify the center of the beveled surface is past the nerve), when the stimulation current reached the minimum (average minimum current: 0.47 mA in group I, 0.37 mA in group II). Indian ink spread over a significant distance (25.4 +/- 0.5 mm [mean standard error]; range, 19-31 mm) longitudinally within the perineural tissue, and axonal degeneration was observed linearly at the peripheral portion of the nerve fascicle in a similar pattern as Indian ink spread. Conclusions: The target nerve was located within 5 mm from the needle with less than 0.5-mA stimulation current. The injectate spread to more than 20 mm on average even when a small volume (100 p,L) of the injectate was injected in rabbit sciatic nerves.
引用
收藏
页码:194 / 200
页数:7
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