Affiliation:
1. Department of Anesthesiology and Intensive Care, Osaka University Graduate School of Medicine, Osaka, Japan
2. Department of Mechanical Science and Bioengineering, Osaka University Graduate School of Engineering Science, Osaka, Japan
Abstract
Abstract
Objective
To perform an effective and safe nerve block, the needle must be placed near the target nerve while avoiding nerve damage. Our objective was to conduct an animal study to determine whether changes in electrical impedance (EI) could be used to guide the needle and achieve a safe and accurate nerve block.
Methods
We measured the EI of rabbit tissues during ultrasound-guided sciatic nerve block using a bipolar needle via the in-plane needle approach. The EI values and needle track on the ultrasound monitor were video-recorded. When there was a change in the EI, the needle advancement was stopped, and a stained anesthetic was injected. Subsequently, the animals were euthanized, and the anesthetic-stained tissue was examined via dissection, while the other tissue was preserved at –80°C for microscopic analysis.
Results
The EI remained stable as the needle advanced through the muscle (extraneural); however, it markedly decreased when the needle tip contacted the nerve or slightly punctured the epineurium (paraneural). The mean extra- and paraneural EIs were 4.92 ± 1.31 kΩ (range, 2.39–9.67 kΩ) and 2.86 ± 0.96 kΩ (range, 1.66–5.13 kΩ), respectively. Examination of the dissections and cryostat sections showed anesthetic delivery around the nerve.
Conclusions
EI values differed between extra- and paraneural sites, and monitoring these values allowed prediction of the needle tip location with respect to the target nerve. Real-time EI measurement could improve the nerve block.
Funder
Japan Society for the Promotion of Science
Publisher
Oxford University Press (OUP)
Subject
Anesthesiology and Pain Medicine,Clinical Neurology,General Medicine