Techniques in Regional Anesthesia & Pain Management
Volume 13, Issue 3 , Pages 121-127, July 2009

Review of ultrasound-guided peripheral nerve stimulation

  • Marc A. Huntoon, MD

      Affiliations

    • Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota
    • Corresponding Author InformationAddress reprint requests and correspondence: Marc A. Huntoon, MD, Division of Pain Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905
  • ,
  • Abram H. Burgher, MD

      Affiliations

    • Center for Pain and Supportive Care, Scottsdale, Arizona

Introduction

Peripheral nerve stimulation has been performed for over four decades, but until recently, no minimally invasive technique has existed. A recently described percutaneous ultrasound (US)-guided needle and electrode placement may allow for improvement in patient selection and optimization of the technique.

Methods

The literature on peripheral nerve stimulation and minimally invasive techniques was reviewed using MEDLINE. Anatomical landmarks and potential technical limitations were also reviewed.

Results

Review of two anatomical feasibility studies, the original cases series, anatomy texts, and other literature suggest that the potential application of US-guided placement of peripheral nerve stimulation systems is feasible. Application of these techniques will, however, require a significant concentrated experience in US evaluation, cross-sectional anatomy, and nerve block technique before attempting.

Conclusions

There is minimal literature at present to suggest that peripheral nerve stimulation systems should be placed using US or other minimally invasive image-guided techniques. As an emerging technique, significant further research will be required to guide future use.

Keywords: Electrical stimulation therapy, Peripheral nerve, Neuropathic pain, Peripheral nerve stimulation

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 Funding: This study was funded in part by a $5000.00 grant from the Department of Anesthesiology, Mayo Clinic Small Grants program. Portions of this review were presented in abstract form at the 2009 American Academy of Pain Medicine annual meeting, Honolulu, HI.

 Competing interests: Dr. Huntoon has current research support from Medtronic and Boston Scientific. The original feasibility studies used needles and leads from Boston Scientific.

PII: S1084-208X(09)00046-9

doi:10.1053/j.trap.2009.06.018

Techniques in Regional Anesthesia & Pain Management
Volume 13, Issue 3 , Pages 121-127, July 2009