{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:23:46Z","timestamp":1790634226261,"version":"4.1.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Anesthesiology"],"published-print":{"date-parts":[[2008,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intraneural injection during peripheral nerve blockade can cause neurologic injury. Current approaches to prevent or detect intraneural injection lack reliability and consistency, or only signal intraneural injection upon the event. A change in electrical impedance (EI) could be indicative of intraneural needle placement before injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>After animal care committee approval, eight pigs were anesthetized and kept spontaneously breathing. In four pigs (part 1), the sciatic nerves were exposed bilaterally for direct needle placement; in a further four pigs (part 2), the tissue was kept intact for ultrasound-guided needle placement. An insulated needle (Sprotte 24 gauge; Pajunk GmbH Medizintechnologie, Geisingen, Germany), attached to a nerve stimulator displaying EI (Braun Stimuplex HNS 12; B. Braun Medical, Bethlehem, PA), was placed extraneurally and then advanced to puncture the nerve sheath. Five punctures within approximately a 1-cm length of each nerve were performed. For each Part, overall EI at each compartment and EI after individual punctures were compared using a general linear model, with post hoc analysis using the Duncan multiple range test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The EI was lower extraneurally compared with intraneurally during open dissection (12.1 +\/- 1.8 vs. 23.2 +\/- 4.4 kOmega; P &lt; 0.0001; n = 8) and when using ultrasound guidance (10.8 +\/- 2.9 vs. 18.2 +\/- 6.1 kOmega; P &lt; 0.0001; n = 7 nerves were visualized adequately). The EI difference was maintained despite performing five sequential punctures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>With further study, EI could prove to be a quantifiable warning signal to alert clinicians to intraneural needle placement, preventing local anesthetic injection and subsequent nerve injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/aln.0b013e318182c288","type":"journal-article","created":{"date-parts":[[2008,8,15]],"date-time":"2008-08-15T03:11:16Z","timestamp":1218769876000},"page":"479-483","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":45,"title":["Electrical Impedance to Distinguish Intraneural from Extraneural Needle Placement in Porcine Nerves during Direct Exposure and Ultrasound Guidance"],"prefix":"10.1097","volume":"109","author":[{"given":"Ban\u00a0C. H.","family":"Tsui","sequence":"first","affiliation":[{"name":"Associate Professor."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer\u00a0J.","family":"Pillay","sequence":"additional","affiliation":[{"name":"Research Assistant."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinny\u00a0T.","family":"Chu","sequence":"additional","affiliation":[{"name":"Research Assistant."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Dillane","sequence":"additional","affiliation":[{"name":"Assistant Professor."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-18-20251013"},{"key":"R2-18-20251013"},{"key":"R3-18-20251013"},{"key":"R4-18-20251013"},{"key":"R5-18-20251013"},{"key":"R6-18-20251013"},{"key":"R7-18-20251013"},{"key":"R8-18-20251013"},{"key":"R9-18-20251013"},{"key":"R10-18-20251013"},{"key":"R11-18-20251013"},{"key":"R12-18-20251013"},{"key":"R13-18-20251013"},{"key":"R14-18-20251013"},{"key":"R15-18-20251013"},{"key":"R16-18-20251013"},{"key":"R17-18-20251013"},{"key":"R18-18-20251013"},{"key":"R19-18-20251013"},{"key":"R20-18-20251013"},{"key":"R23-18-20251013"}],"container-title":["Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pubs.asahq.org\/anesthesiology\/article-pdf\/109\/3\/479\/656192\/0000542-200809000-00018.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.lww.com\/00000542-200809000-00017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T16:00:40Z","timestamp":1760371240000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00000542-200809000-00017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,9,1]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2008]]}},"URL":"https:\/\/doi.org\/10.1097\/aln.0b013e318182c288","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1131964.589981","asserted-by":"object"}]},"ISSN":["0003-3022"],"issn-type":[{"value":"0003-3022","type":"print"}],"subject":[],"published":{"date-parts":[[2008,9,1]]}}}