naa a22 4500 510743536 CHVBK 20180411083036.0 cr unu---uuuuu 180411e20130301xx s 000 0 eng 10.1007/s12630-012-9845-y doi (NATIONALLICENCE)springer-10.1007/s12630-012-9845-y Electrical impedance to detect accidental nerve puncture during ultrasound-guided peripheral nerve blocks [Elektronische Daten] [Patrick Bardou, Jean-Christophe Merle, Jean-Baptiste Woillard, Nathalie Nathan-Denizot, Pierre Beaulieu] L'utilisation de l'impédance électrique pour détecter une ponction nerveuse accidentelle pendant un bloc nerveux périphérique échoguidé Purpose: The objective of this study was to assess if an increase in electrical impedance was associated with intraneural (sub-epineural) needle tip placement. Methods: Two electrical impedance measurements were carried out in each of 140 peripheral nerve blocks. The first measurement was performed at a distance of 0.5-1cm from the nerve trunk (reference value), and the second measurement was performed close to the nerve, either immediately before local anesthetic injection if no nerve puncture was suspected, or immediately before repositioning the needle if nerve puncture was suspected. Nerve puncture was suspected if any one of the following indications was present: pain or paresthesia; motor responses with a minimal stimulating current<0.4mA; needle tip observed inside the nerve using ultrasound; nerve swelling after injection of local anesthetic. Electrical impedance variations were compared between the no puncture and the suspected puncture groups. Results: Nerve puncture was suspected in 21 cases. The median variation [quartiles] of electrical impedance was +6.6% [−20; 36%] in the suspected puncture group (n=21) and −10.0% [−28; 0%] in the no puncture group (n=119) (P=0.02). Absolute values of electrical impedance close to the nerve were greater in the suspected puncture group (15.5kΩ [12.0; 18.0kΩ]) vs the no puncture group (12.0kΩ [8.9; 15.1% kΩ]) (P=0.013). A receiver operating characteristic (ROC) curve was constructed, and the optimal cut-off for impedance was +4.3%. Conclusion: A>4.3% increase in electrical impedance may indicate accidental nerve puncture during peripheral nerve block. Canadian Anesthesiologists' Society, 2012 Bardou Patrick Department of Anesthesiology, Limoges University Hospital Center, CHU Limoges, 2 avenue Martin Luther King, 87042, Limoges Cedex, France aut Merle Jean-Christophe Department of Anesthesiology, Limoges University Hospital Center, CHU Limoges, 2 avenue Martin Luther King, 87042, Limoges Cedex, France aut Woillard Jean-Baptiste Department of Pharmacology and Toxicology, CHU Limoges, Limoges, France aut Nathan-Denizot Nathalie Department of Anesthesiology, Limoges University Hospital Center, CHU Limoges, 2 avenue Martin Luther King, 87042, Limoges Cedex, France aut Beaulieu Pierre Department of Anesthesiology, Limoges University Hospital Center, CHU Limoges, 2 avenue Martin Luther King, 87042, Limoges Cedex, France aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 253-258 0832-610X 60:3<253 2013 60 12630 https://doi.org/10.1007/s12630-012-9845-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9845-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bardou Patrick Department of Anesthesiology, Limoges University Hospital Center, CHU Limoges, 2 avenue Martin Luther King, 87042, Limoges Cedex, France aut NATIONALLICENCE 700 1- Merle Jean-Christophe Department of Anesthesiology, Limoges University Hospital Center, CHU Limoges, 2 avenue Martin Luther King, 87042, Limoges Cedex, France aut NATIONALLICENCE 700 1- Woillard Jean-Baptiste Department of Pharmacology and Toxicology, CHU Limoges, Limoges, France aut NATIONALLICENCE 700 1- Nathan-Denizot Nathalie Department of Anesthesiology, Limoges University Hospital Center, CHU Limoges, 2 avenue Martin Luther King, 87042, Limoges Cedex, France aut NATIONALLICENCE 700 1- Beaulieu Pierre Department of Anesthesiology, Limoges University Hospital Center, CHU Limoges, 2 avenue Martin Luther King, 87042, Limoges Cedex, France aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 253-258 0832-610X 60:3<253 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer