Finite-difference modeling of the anisotropic electric fields generated by stimulating needles used for catheter placement.

The use of peripheral nerve blocks to control pain is an increasing practice. Many techniques include the use of stimulating needles to locate the nerve of interest. Though success rates are generally high, difficulties still exist.

Neostigmine-induced prolonged neuromuscular blockade in a patient with atypical pseudocholinesterase.

A patient with unrecognized atypical pseudocholinesterase was given succinylcholine and then vecuronium before neuromuscular monitoring was instituted. Subsequently, when neostigmine and glycopyrrolate were given to reverse what was thought to be a nondepolarizing block, the patient became further relaxed, and his trachea could not be extubated for more than 10 hours. In this report, we discuss drug interactions, phase II block, and the importance of timely neuromuscular monitoring.