Combined Ultrasound and Nerve Stimulator-guided Deep Nerve Block May Decrease the Rate of Local Anesthetics Systemic Toxicity

A Randomized Clinical Trial

Xu-hao Zhang; Yu-jie Li; Wen-quan He; Chun-yong Yang; Jian-teng Gu; Kai-zhi Lu; Bin Y


BMC Anesthesiol. 2019;19(103) 

In This Article


This study was approved by the Ethical Committee of the First Affiliated Hospital of Army Medical University (previous name: Southwest Hospital of the Third Military Medical University). The protocol was registered prospectively with the Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15, 2016. The principal investigator was Bin Yi. The study took place at the Department of Anesthesia, the First Affiliated Hospital, Army Medical University, Chongqing, from August 25, 2016, to August 14, 2017.

Patients scheduled for elective lower limb surgery in the Southwest Hospital and desiring LPBs and SNBs were offered enrolment. Written informed consent was obtained from the participants for publication of this article and any accompanying Tables. A copy of the written consent is available for review by the Editor of this journal. The inclusion criteria were as follows: willingness to participate in the study (written informed consent); ASA classification of I to III; older than 18 years old. The exclusion criteria were as follows: refusal to participate; history of neurological diseases; coagulopathy or infection at the site of the block, allergy to local anesthetics (LAs), and any contraindication to peripheral nerve blockade noted by the attending anesthesiologist. All patients were randomly allocated to group U (ultrasound guidance), group N (nerve stimulator guidance) or group M (combined guidance) by a random number table.