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Safety and Efficacy of the Infraclavicular Nerve Block Performed at Low Current
Authors:Mitchell T Keschner  MD  ; Heidi Michelsen  MD  ; Andrew D Rosenberg  MD  ; Daniel Wambold  MD  ; David B Albert  MD  ; Robert Altman  MD  ; Steven Green  MD  ; Martin Posner  MD
Institution:Departments of Anesthesiology and Orthopedics, NYU Hospital for Joint Diseases New York City, New York, U.S.A.
Abstract:Abstract:   It has recently been suggested that peripheral nerve or plexus blocks performed with the use of a nerve stimulator at low currents (<0.5 mA) may result in neurologic damage. We studied the infraclavicular nerve block, performed with the use of a nerve stimulator and an insulated needle, in a prospective evaluation of efficacy and safety. During a one-year period, 248 patients undergoing infraclavicular nerve block were evaluated for block success rate and incidence of neurologic complication. All blocks were performed with the use of a nerve stimulator and an insulated needle at ≤0.3 mA. Success rate was 94%, which increased to 96% with surgical infiltration of local anesthetic. There were no intraoperative or immediate postoperative complications noted. After one week, only one patient had a neurologic complaint, and this was surgically related, referable to surgery performed on the radial nerve. We conclude that infraclavicular nerve blocks performed at low currents (≤0.3 mA) are safe and effective.
Keywords:Infraclavicular nerve block  neurologic complications  regional anesthesia  low current
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