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[外周神经刺激器在神经和神经丛阻滞实施中的作用]

[The function of peripheral nerve stimulators in the implementation of nerve and plexus blocks].

作者信息

Kaiser H, Niesel H C, Hans V, Klimpel L

机构信息

Anaesthesie-Abteilung des St. Marien- und St. Annastiftskrankenhauses Ludwigshafen.

出版信息

Reg Anaesth. 1990 Sep;13(7):172-8.

PMID:2236715
Abstract

A selection of nine instruments supplied by eight different manufacturers for carrying out peripheral nerve stimulation were checked for their suitability, safety and ease of operation, and were compared and contrasted with reference to a spectrum of characteristics that appear desirable in theoretical and practical terms. Measurements at Ohm's resistance showed that in the clinically relevant range of impulse amplitudes (0.1-1.0 mA) the quality of adjustment of the instruments varied widely. The actual electrical impulse delivered by some of the instruments deviated so widely from the adjusted theoretical value that they must be regarded as unsuitable. The duration of the impulse corresponded to the manufacturer's specifications for only two instruments. Four instruments did not generate a monophasic square-wave signal despite assertions to the contrary in the instructions for use, and one instrument did generate such a signal although a "special biphasic asymmetrical" impulse is described by the manufacturer. Impulse-like overshooting at the beginning of the signal, oscillations into the positive range at the end of the signal and fall in current during the course of the signal were the form variants indicating technically inadequate design in the other instruments. Resistance to the square-wave current impulse engendered by the complex body resistance (impedance), a good approximation to the mathematical e-function to be expected, could be demonstrated for the rising signal flank, whereas the signal curve in the lower part of the descending flank was flatter than expected owing to polarization effects in the body tissue. The characteristic voltage and time values calculated for the signal curves are shown in tables.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对八家不同制造商提供的九种用于外周神经刺激的仪器进行了适用性、安全性和操作简便性检查,并根据理论和实际中理想的一系列特性进行了比较和对照。欧姆电阻测量表明,在临床相关的脉冲幅度范围(0.1 - 1.0 mA)内,仪器的调节质量差异很大。一些仪器实际发出的电脉冲与调节后的理论值偏差过大,必须视为不合适。只有两台仪器的脉冲持续时间符合制造商的规格。尽管使用说明书中有相反的说明,但仍有四台仪器未产生单相方波信号,而有一台仪器虽制造商描述为“特殊双相不对称”脉冲,但实际产生了这样的信号。信号开始时类似脉冲的过冲、信号结束时进入正范围的振荡以及信号过程中的电流下降是其他仪器在技术设计上存在不足的形式变体。对于上升信号沿,可以证明由复杂人体电阻(阻抗)产生的方波电流脉冲的电阻,很好地近似于预期的数学指数函数,而由于人体组织中的极化效应,下降沿下部的信号曲线比预期更平坦。信号曲线计算出的特征电压和时间值列于表中。(摘要截选至250字)

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