Do we really need a nerve stimulator for regional blocks?

Objective / Methods: Since the introduction of nerve stimulation into clini cal practice there has been controversy about the possible benefit. We carr ied out a Medline(R) based analysis of current literature to investigate wh ether a nerve stimulator prevents nerve injury and increases the success ra te for regional blocks, Results: Concerning superficial nervous structures the success rate is not increased by the use of a nerve stimulator (Table 1 - 3). The axillary block of the brachial plexus has a total success rate o f 91% without nerve stimulator and 75% with nerve stimulator (Table 2/3). T he nerve stimulator does not prevent nerve injury. In contrast, it can be a nticipated that with the closer approach of the stimulator needle to the ne rves a nerve injury might even be more frequent. Conclusion: In certain oth er blocks (e.g. sciatic nerve block infraclavicular plexus block) the ident ification of the perinervous sheat in the depth of the tissue is difficult. In these types of block a nerve stimulator is a good help. In all other cases the nerve stimulator does neither prevent from nerve dam age nor increase the success rate of the block.