Nerve Stimulator for Patients With Upper Extremity Disease, Vascular or Orthopedic Surgery

Does the Use of a Nerve Stimulator Improve the Outcome of Ultrasound-Guided Supraclavicular Block (Anesthesia) for Upper Extremity Surgery?

To help determine if there is improved pain relief when a device that makes an arm muscle move (nerve stimulator) is used to place a needle in the area above the collarbone to prevent feeling of pain (anesthesia) of the upper arm.

The Investigators will use the assessment of onset of motor and sensory block Q 5 minutes to distinguish the difference between blocks performed with ultrasound guidance with or without a nerve blockade monitor.

Inclusion Criteria:

• Adult male and females 21 through 89
• Agree to study participation and signed the informed consent
• Scheduled for upper extremity surgery with ultrasound guided supraclavicular block -

Exclusion Criteria:

• Children
• Pregnant Women
• Persons with allergies to local anesthetics
• Persons with infections at or near site of needle insertion
• Patients with severe disturbance of cardiac rhythm and heart block
• Patients with severe respiratory compromise
• Patients requiring bilateral upper extremity anesthesia
• Patients with coagulopathy or medical anticoagulation
• Patients with traumatic nerve injury to neck or upper extremity
• Patients with preexisting neurological deficits in the distribution of the block
• Patients with previous surgery to the neck that may distort brachial plexus anatomy