Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Med Hypotheses. 2017 Sep;107:72-73. doi: 10.1016/j.mehy.2017.08.018. Epub 2017 Aug 16.
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 0.4-0.5mA using an impulse width of 0.1ms. 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 1.0mA (0.1ms) 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.
区域神经丛阻滞和神经阻滞是现代麻醉中常用的技术。由于许多科室都配备了超声机,神经刺激的作用受到了高度的讨论,并且考虑了不同的阻滞方法。电神经刺激的常用技术是使用脉冲宽度为 0.1ms 的 0.4-0.5mA 的刺激阈值进行搜索。我们提出了使用所有可能信息的假设,提出了一种新的保护神经刺激概念,并提供了支持我们理论的初步数据。在超声引导神经阻滞中的保护性神经刺激中,在阻滞过程中不改变任何参数的情况下,使用 1.0mA(0.1ms)的固定电流。目的是在注射前和注射过程中没有肌肉抽搐。如果这种神经轴阻滞方法能带来合适的效果,我们应该考虑新的电流设置,以便在神经损伤风险较低、患者舒适度较高的情况下进行更安全的阻滞,特别是在可视性差的阻滞情况下。