Different pulse shapes for selective large fibre block in sacral nerve roots using a technique of anodal block: an experimental study.

The aim of this study was experimentally to investigate whether it is possible to reduce the charge per phase that is applied during selective large fibre block. Sacral roots in pigs were stimulated. Sacral roots contain large somatic nerve fibres and small parasympathetic nerve fibres. Large nerve fibres that innervate the external urethral and external anal sphincters were selectively blocked using a technique of anodal block. In that way, selective activation of the detrusor muscle and the rectum innervated by parasympathetic fibres could be obtained. The square stimulation pulse was replaced with three different pulse shapes that had the same duration as the square pulse and consisted of a depolarising prepulse and a blocking part of the pulse. Compared with the square pulse, the charge per phase needed for anodal block could be reduced with all three pulse shapes. Maximum reduction of the charge per pulse was 17+/-6%. A lower charge might make anodal block safer in long-term applications.