Supramaximal excitation of the brachial plexus by percutaneous monopolar stimulation

Objective: To demonstrate that percutaneous monopolar stimulation of the brachial plexus at Erb's point allows supramaximal excitation of the brachial plexus without provoking adverse effects. Methods: We analysed retrospectively brachial plexus stimulation data from 1105 consecutive examinations. Monopolar plexus stimuli were applied as previously described (Roth and Magistris, 1987) using a small cathode electrode (diameter 3cm) taped over Erb's point and a large remote anode electrode (surface area 32cm2) taped over the internal region of the suprascapular fossa. Compound muscle action potentials (CMAPs) were…