Equipment and Clinical Practice: Aids to Localization of Peripheral Nerves

  • Bryan Tischenkel
  • Beverly Pearce-Smith
  • Johnny K. Lee
  • Karina Gritsenko
Chapter

Abstract

Although advances in technology have allowed for various shortcuts in the identification of nerves, nerve location begins by identifying standard anatomical landmarks and understanding the anatomic variations which can exist. The recognition of fundamental anatomy can serve as a basis for subsequent invasive needle exploration, which has only been improved with newer tools that optimize precision and safety.

A successful endpoint can be reached through anatomy, functionally via a sensory paresthesia, via a motor response to electrical nerve stimulation (NS), and via ultrasonography (real-time imaging). Ultrasonography has gained the most popularity in recent years, but basic anatomic knowledge as well as concurrent nerve twitch stimulation can provide added information and success.

Keywords

Peripheral nerve stimulator Ultrasound Positioning devices Echogenic needles Echogenic catheters Skin preparation Twitch monitor 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Bryan Tischenkel
    • 1
  • Beverly Pearce-Smith
    • 2
  • Johnny K. Lee
    • 3
  • Karina Gritsenko
    • 4
  1. 1.Department of AnesthesiologyMontefiore Medical CenterBronxUSA
  2. 2.Department of AnesthesiologyPresbyterian University Hospital, University of Pittsburgh Medical CenterPittsburghUSA
  3. 3.Department of AnesthesiologyNorthShore University Health SystemChicagoUSA
  4. 4.Regional Anesthesia and Acute Pain Medicine, Department of AnesthesiologyMontefiore Medical Center—Albert Einstein College of MedicineBronxUSA

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