Case series: ultrasound-guided supraclavicular block using a curvilinear probe in 104 day-case hand surgery patients.

Purpose: To report our experiences regarding the implementation of a combined ultrasound and nerve stimulation guidance technique for supraclavicular blockade in day-case hand surgery patients at our institution.

Clinical Features: We retrospectively reviewed 104 patient charts from the first 6 months of our clinical practice of using this block approach for upper extremity surgery. Block success, completion and recovery time, post-block analgesia requirement, acute complication rate, and duration of hospital stay were evaluated and categorized based on the practitioner who performed the block (fellow/staff anesthesiologists and residents), as well as the body mass index of the patient (when available).

Electrical impedance to distinguish intraneural from extraneural needle placement in porcine nerves during direct exposure and ultrasound guidance.

Background: Intraneural injection during peripheral nerve blockade can cause neurologic injury. Current approaches to prevent or detect intraneural injection lack reliability and consistency, or only signal intraneural injection upon the event. A change in electrical impedance (EI) could be indicative of intraneural needle placement before injection.