The Application Of Percutaneous Nerve Stimulation Pen Combining Nerve Stimulator In Axillary Brachial Plexus Block

ObjectiveTo valuate the application of percutaneous nerve stimulation pen combining nerve stimulator in multi-injection axillary brachial plexus block by localizing musculocutaneous nerve, radial nerve, median nerve and ulnar nerve.Methods40patients who were going to do forearm or hand surgery were randomly divided into study group and control group, and each group had20patients. In the study group, we performed nerve localization and block by percutaneous nerve stimulation pen first, then by the nerve stimulator, however, we performed nerve localization and block only by the nerve stimulator. In both group were performed axillary brachial plexus block by multi-injection technique, which localized musculocutaneous nerve, radial nerve, median nerve and ulnar nerve in turn, after successful localization each point were injected0.375%ropivacaine10ml. Record the situation of nerve localization, including the succeed ratio, puncture depth, puncture time, the adverse reaction of vascular injury and so on, meanwhile, assessed the situation of sensory and motor block and record the time of sensory and motor block successfully.ResultsAll patients were succeed in surgery smoothly without adjuvant drug, the block success rate is100%in both groups. The total operation time, each nerve localization success rate, the needle puncture depth, the time needed for the sensory and motor nerve block thoroughly during complete axillary brachial plexus block had no statistical significance difference(P>0.05); But the puncture time of musculocutaneous nerve, radial nerve and median nerve in study group were significantly shorter than the control group (P<0.01,0.05), the puncture time of ulnar nerve in both group had no statistical significance difference (P>0.05). There occurred vascular injury for1case in study group and3cases in control group, and the other complications such as nerve damage was not occurred in two groups, the differences of complications between the two groups had no statistical significance (P>0.05).ConclusionPercutaneous nerve stimulation pen could provide very good auxiliary in musculocutaneous nerve radial nerve and median nerve block,with the help of percutaneous nerve stimulation pen, we could significantly shorten the puncture time of musculocutaneous nerves、radial nerve and median nerve.