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Erschienen in: Der Anaesthesist 7/2014

01.07.2014 | Leitlinien und Empfehlungen

Nerve localization for peripheral regional anesthesia

Recommendations of the German Society of Anaesthesiology and Intensive Care Medicine

verfasst von: T. Steinfeldt, MD, U. Schwemmer, T. Volk, M. Neuburger, T. Wiesmann, A.R. Heller, O. Vicent, A. Stanek, M. Franz, H. Wulf, P. Kessler

Erschienen in: Die Anaesthesiologie | Ausgabe 7/2014

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Abstract

The German Society of Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin, DGAI) established an expert panel to develop preliminary recommendations for nerve localization in peripheral regional anesthesia. Based on expert knowledge and the relatively limited data, the recommendations state how ultrasound and/or electrical nerve stimulation should be used in daily practice, and where and when local anesthetics should be injected. Moreover, it was defined under which conditions a peripheral nerve block under general anesthesia or deep sedation is applicable.
Regarding the use of ultrasound the expert opinion was that out-of-plane and in-plane-techniques can be considered equal with respect to patient safety. Nevertheless, the direct or indirect visualization of the needle tip has to be assured. The injection of local anesthetics has to be visualized. Injections into nerves or those requiring an injection pressure should be avoided. The sole use of electrical nerve stimulation or ultrasound for nerve localization is still a suitable option as well as their combined use. To avoid accidental intraneural needle placement, an electrical current threshold ≥ 0.5 mA should be used. Moreover, it was stated that peripheral nerve blocks or continuous nerve block techniques under sedation or general anesthesia are applicable in adult patients who are unable to tolerate the block being performed in an awake state or have difficulty cooperating.
This article is published in English.
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Metadaten
Titel
Nerve localization for peripheral regional anesthesia
Recommendations of the German Society of Anaesthesiology and Intensive Care Medicine
verfasst von
T. Steinfeldt, MD
U. Schwemmer
T. Volk
M. Neuburger
T. Wiesmann
A.R. Heller
O. Vicent
A. Stanek
M. Franz
H. Wulf
P. Kessler
Publikationsdatum
01.07.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Anaesthesiologie / Ausgabe 7/2014
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-014-2343-6

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