Methods of nerve localization during peripheral nerve block in some hospitals in Nigeria

Abstract

Background: The correct needle placement and deposition of the local anaesthetic agent in proximity to the intended nerve is the hallmark of a peripheral nerve block (PNB).

Methods: This questionnaire-based study investigated the various methods of nerve localization during peripheral nerve block by anaesthetists in Nigeria and the pattern of utilization. A total of 120 questionnaires were distributed to 6 tertiary hospitals in Nigeria to elicit responses on the approaches to nerve localization at PNB. The commonly practiced methods of nerve localization and reasons for the performance or non-performance of the various approaches were also interrogated.

Results: A total of one hundred and nine (109) of the one hundred and twenty (120) questionnaires were returned (response rate of 90.8%). The majority of respondents (71.6%) were male. The cadres of respondents were Registrar (49.5%), Senior Registrar (27.5%), and Consultant (23.0%). The Anatomical approach was the most utilized (45.9%) as compared to Peripheral Nerve Stimulation (24.8%), Ultrasound-guided blocks (12.8%), or combined Peripheral Nerve Stimulation and ultrasound-guided blocks (16.5%). Lack of skills (73.4%) and absence of appropriate technology (26.6%) were the major reasons for the non-performance of some methods of nerve localization.

Conclusion: This survey indicates that Anaesthesiologists in Nigeria use mainly the anatomical approach to peripheral nerve block. Emphasis should be on personnel development rather than over-reliance on hi-tech approaches to nerve localization as this will allow for widespread application of available methods.