Intraneural Injection Techniques and Peripheral Nerve Injury Management
Summary
Intraneural injection techniques have evolved considerably with the advent of real-time imaging and pressure-sensing technologies, reshaping the prevention and management of peripheral nerve injury. At its core, the practice balances effective local anaesthetic delivery against the risk of mechanical trauma and high-pressure insults within the nerve. Modern strategies integrate ultrasound guidance to visualise nerve fascicles, nerve stimulation to confirm safe needle-nerve distance and injection pressure monitoring to detect elevated resistance indicative of intrafascicular placement. When injury occurs, prompt recognition through clinical assessment and electrodiagnostic testing informs conservative measures—such as physiotherapy, pharmacological neuroprotection and close neurological follow-up—or surgical interventions including neurolysis and grafting. This integrated framework addresses both acute prevention and long-term recovery, with implications for improved pain management, safer regional anaesthesia and enhanced functional outcomes in diverse patient populations worldwide.
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Intraneural Injection Techniques and Peripheral Nerve Injury Management publication trend
The graph below shows the total number of articles in intraneural injection techniques and peripheral nerve injury management across all publications each year (not limited to Nature Index journals).
Technical terms
Intraneural injection: passage of needle or fluid directly into the internal substance of a peripheral nerve, risking mechanical and pressure‐related injury.
Perineural injection: delivery of local anaesthetic around the nerve sheath, minimising direct trauma to nerve fibres.
Injection pressure monitoring: measurement of resistance during anaesthetic injection to detect elevated pressures indicative of intrafascicular placement.
Ultrasound guidance: real-time imaging of nerves and adjacent structures to visualise needle trajectory and anaesthetic distribution.
Nerve stimulation: application of low-threshold electrical current to elicit motor responses, confirming needle proximity without intraneural penetration.
References
- Nerve Injury Following Regional Nerve Block: A Literature Review of Its Etiologies, Risk Factors, and Prevention. Current Pain and Headache Reports (2024).
- Multimodal Approach in Minimizing Transient Neurological Complications Following Single Shot Brachial Plexus Block: A Prospective Observational Study. Cureus (2023).
- The Safety of Peripheral Nerve Blocks: The Role of Triple Monitoring in Regional Anaesthesia, a Comprehensive Review. Healthcare (2024).
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