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“Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part C (Prevention of Nerve Injuries)
“A clever person solves the problem. A wise person avoids it” (Albert Einstein). There is no convincing evidence that any modality 100% effectively prevents nerve injury. The risk of nerve injury remains the same even with the ultrasound due to limitations in the resolution of images and inter-opera...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423097/ https://www.ncbi.nlm.nih.gov/pubmed/37581128 http://dx.doi.org/10.7759/cureus.41847 |
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author | Sonawane, Kartik Dixit, Hrudini Mehta, Kaveri Thota, Navya Gurumoorthi, Palanichamy |
author_facet | Sonawane, Kartik Dixit, Hrudini Mehta, Kaveri Thota, Navya Gurumoorthi, Palanichamy |
author_sort | Sonawane, Kartik |
collection | PubMed |
description | “A clever person solves the problem. A wise person avoids it” (Albert Einstein). There is no convincing evidence that any modality 100% effectively prevents nerve injury. The risk of nerve injury remains the same even with the ultrasound due to limitations in the resolution of images and inter-operator and inter-patient differences. In a nutshell, caution is required when dealing with precious nerves in the perioperative period, either during peripheral nerve blocks (PNBs), patient positioning, or surgery. Identifying pre-existing nerve injury, either due to trauma or an existing neuropathy, and preventing further nerve injury should be an important goal in providing safe regional anesthesia (RA). Multimodal monitoring is key to avoiding multifactorial nerve injuries. The use of triple guidance (ultrasound + peripheral nerve stimulator + injection pressure monitor) during PNBs further improves the safety of RA. The ultrasound helps in real-time visualization of the nerve, needle, and drug spread; the peripheral nerve stimulator helps confirm the target nerves; and the injection pressure monitor helps avoid nerve injury. Such multimodalities can also give the confidence to administer PNB without risk of nerve injury. This article is part of the comprehensive overview of the essential understanding of peripheral nerves before blocking them. It describes various preventive measures to avoid peripheral nerve injuries while administering PNBs. It will help readers understand the importance of prevention in each step to avoid perioperative PNIs. |
format | Online Article Text |
id | pubmed-10423097 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-104230972023-08-14 “Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part C (Prevention of Nerve Injuries) Sonawane, Kartik Dixit, Hrudini Mehta, Kaveri Thota, Navya Gurumoorthi, Palanichamy Cureus Anesthesiology “A clever person solves the problem. A wise person avoids it” (Albert Einstein). There is no convincing evidence that any modality 100% effectively prevents nerve injury. The risk of nerve injury remains the same even with the ultrasound due to limitations in the resolution of images and inter-operator and inter-patient differences. In a nutshell, caution is required when dealing with precious nerves in the perioperative period, either during peripheral nerve blocks (PNBs), patient positioning, or surgery. Identifying pre-existing nerve injury, either due to trauma or an existing neuropathy, and preventing further nerve injury should be an important goal in providing safe regional anesthesia (RA). Multimodal monitoring is key to avoiding multifactorial nerve injuries. The use of triple guidance (ultrasound + peripheral nerve stimulator + injection pressure monitor) during PNBs further improves the safety of RA. The ultrasound helps in real-time visualization of the nerve, needle, and drug spread; the peripheral nerve stimulator helps confirm the target nerves; and the injection pressure monitor helps avoid nerve injury. Such multimodalities can also give the confidence to administer PNB without risk of nerve injury. This article is part of the comprehensive overview of the essential understanding of peripheral nerves before blocking them. It describes various preventive measures to avoid peripheral nerve injuries while administering PNBs. It will help readers understand the importance of prevention in each step to avoid perioperative PNIs. Cureus 2023-07-13 /pmc/articles/PMC10423097/ /pubmed/37581128 http://dx.doi.org/10.7759/cureus.41847 Text en Copyright © 2023, Sonawane et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Anesthesiology Sonawane, Kartik Dixit, Hrudini Mehta, Kaveri Thota, Navya Gurumoorthi, Palanichamy “Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part C (Prevention of Nerve Injuries) |
title | “Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part C (Prevention of Nerve Injuries) |
title_full | “Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part C (Prevention of Nerve Injuries) |
title_fullStr | “Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part C (Prevention of Nerve Injuries) |
title_full_unstemmed | “Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part C (Prevention of Nerve Injuries) |
title_short | “Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part C (Prevention of Nerve Injuries) |
title_sort | “knowing it before blocking it,” the abcd of the peripheral nerves: part c (prevention of nerve injuries) |
topic | Anesthesiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423097/ https://www.ncbi.nlm.nih.gov/pubmed/37581128 http://dx.doi.org/10.7759/cureus.41847 |
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