Effect of nerve localization using a pen device on the success of axillary brachial plexus block

Abstract

Objective: The effectiveness of axillary brachial plexus block (ABPB) performed using peripheral nerve stimulation (PNS) alone was compared with PNS preceded by nerve localization using a pen device, enabling nerve mapping without puncturing the skin. Methods: Patients undergoing unilateral hand or forearm surgery suitable for ABPB were randomly assigned to receive either PNS alone (pen-group) or PNS preceded by nerve localization using a pen device (pen+group). Parameters related to the block procedure and patient comfort were assessed. Results: Thirty patients were included in each group. The block performance time was longer in the pen+group than the pen-group despite a reduced number of needle insertions. The complete block rate was higher and intraoperative analgesic usage lower in the pen+group compared with the pen-group. Patient satisfaction and complication rates were similar in the two groups. Conclusion: The pen device seems to be a helpful addition to PNS for ABPB, with improved results in terms of block success and patient comfort, but further studies are needed to confirm these findings. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.