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LETTER TO EDITOR
Year : 2012  |  Volume : 6  |  Issue : 3  |  Page : 311

Indigenous drug delivery system for use in nerve blocks


Department of Anaesthesia and Intensive Care, Government Medical College, Chandigarh, India

Correspondence Address:
Parampreet Singh
Department of Anaesthesia and Intensive Care, Government Medical College, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.101237

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Date of Web Publication21-Sep-2012
 


How to cite this article:
Singh P, Gombar SK, Bajaj N. Indigenous drug delivery system for use in nerve blocks. Saudi J Anaesth 2012;6:311

How to cite this URL:
Singh P, Gombar SK, Bajaj N. Indigenous drug delivery system for use in nerve blocks. Saudi J Anaesth [serial online] 2012 [cited 2020 Jul 10];6:311. Available from: http://www.saudija.org/text.asp?2012/6/3/311/101237

Sir,

Nerve blocks form the backbone of regional anesthesia, and require experience and thorough anatomical knowledge in order to achieve adequate anesthesia. [1] Various factors determine the adequacy of the anesthesia achieved, like eliciting paraesthesia in the nerve root area, volume and concentration of the drug used and, the most challenging, the technique of drug delivery. Even the most experienced anesthesiologist needs to be cautious against inadvertent displacement of the needle while delivering the drug, and requires precise control of the needle to prevent inadequate anesthesia or complications associated with regional anesthesia. [2] Conventionally, the Stimuplex needle (stimulation needle) is used to localize the nerve and drug delivery during the regional nerve block. Because of the cost constraints and, at times, nonavailability of this needle, we designed an indigenous drug delivery system using a standard 22-gauge 1.5-inch needle, a three-way stop cock and cut-segment of the intravenous infusion set [Figure 1].
Figure 1: The complete assembly

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The assembly includes:

  • Needle: A 20-G needle to locate the nerve. Size of needle varies with the type of block desired.
  • Three-way stop cock: It helps in proper holding of the needle while fixing the needle for drug delivery.
  • Cut-segment of the infusion set: It is cut in such a way that it can easily be attached with one of the ports of the three-way stopcock.
  • A 5 or 10 cc syringe: This is connected to the infusion set through a three-way stopcock and is used for delivering the drug without any undue movement of the needle.
This simple system has several advantages. The assembly is air tight, and this can be checked by creating vacuum in the syringe when all the ports of the three-way stopcocks are closed. Further entry of air can be prevented by filling the system with the drug prior to use. Because it avoids any spillage of the drug, an accurate volume can be administered. It can easily be assembled in the operating room as all the components are readily available. This is especially advantageous in a set-up like ours, where patients are unwilling/unable to spend on expensive commercial kits available for drug administration for blocks. Also, this arrangement provides a stable grip on the needle and prevents displacement while the drug is being given by the assistant. The assembly has been especially useful during ultrasound-guided nerve blocks, where one hand of the operator is holding the ultrasound probe to locate the nerve and other hand is inserting the needle. Once the needle tip is located at the right place, the drug can be injected by the assistant without moving the needle or probe. We have routinely used this system in our set-up for various blocks like Transversus Abdominis Plane block, brachial plexus block, etc. with or without ultrasound guidance.

 
  References Top

1.Neal JM, Gerancher JC, Hebl JR, Ilfeld BM, McCartney CJL, Franco CD, et al. Upper Extremity Regional Anesthesia: Essentials of Our Current Understanding, 2008. Reg Anesth Pain Med 2009;34:134-70.  Back to cited text no. 1
    
2.Yves A, Patrick N, Antoine M, Lawrence L, Bernard R, Kamran S. Serious complications related to regional anaesthesia: Results of a prospective survey in France. Anesthesiology 1997;87:479-86.  Back to cited text no. 2
    


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This article has been cited by
1 A superior drug delivery system for peripheral nerve block procedures
Shetti, A.N.
Saudi Journal of Anaesthesia. 2013; 7(1): 96
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