|LETTER TO EDITOR
|Year : 2015 | Volume
| Issue : 1 | Page : 62
Peripheral nerve block needle defect
Uday S Ambi, Joselo Delute Macachor, Khalil Shibli
Department of Anaesthesia, Khoo Tech Paut Hospital, Yishun, Singapore
|Date of Web Publication||16-Jan-2015|
Dr. Uday S Ambi
Clinical Fellow, Regional Anaesthesia, Khoo Tech Paut Hospital, Yishun, Singapore - 680547
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ambi US, Macachor JD, Shibli K. Peripheral nerve block needle defect. Indian J Anaesth 2015;59:62
Many unusual findings related to regional anaesthesia equipment have been reported. , We recently encountered a manufacturing defect in a regional block needle that has not been described to date.
A 65 year old, ASA-3, patient was scheduled for right ankle wound debridement. Ultrasound guided anterior sciatic and femoral block with a 21 gauge, 100 mm insulated peripheral block needle (Stimuplex®, A100, B Braun, Melsungen, Germany) was planned.
In our operating theatre, the regional anaesthesia block area (RABA) is dedicated for the regional procedures. RABA is equipped with drugs, ultrasound machine, monitoring and nursing assistant. After consenting and checking for the laterality, patient was positioned and site pre-scanned. The linear array ultrasound probe position was marked with a non-erasable marker and subsequently operator scrubbed. Preparation included cleaning the site, drawing drugs and priming the tube and the block needle with ropivacaine 0.5%. The needle is normally covered with a protective open-ended plastic sheath which is removed just before needle insertion. In this case, after all the preparation including skin infiltration with 1% lignocaine and probe fixation, procedurist attempted to withdraw or remove the outer sheath. We could notice that the outer sheath was totally embedded within the hub, and we were unable to remove even on applying considerable pulling force [Figure 1]. Procedure was continued with another needle.
|Figure 1: Normal (a) and faulty (b) peripheral block needles. Solid arrowhead showing the embedded sheath within the hub|
Click here to view
B Braun Division, Singapore did confirm this malfunction after close examination of the equipment sent to them and reported it as an isolated incident. Like many other anaesthesiologists, we take it for granted that regional anaesthesia tools are fool-proof. Although there were no harmful consequences of this incident, this emphasises mandatory pre-procedural equipment check.
| References|| |
Shirgaonkar A, Russell IF. To check or not to check - That is the question? Anaesthesia 2008;63:677-8.
Stevens J. Faulty Tuohy needle. Anaesthesia 1999;54:1120.