209 Injecting pressures during regional anaesthesia. Can practitioners predict safety objectively?

Autor: D White, James Stimpson, Peter Young, Robin Heij, S Southey, B. Fox
Rok vydání: 2021
Předmět:
Zdroj: Peripheral nerve blocks.
DOI: 10.1136/rapm-2021-esra.209
Popis: Background and Aims Nerve injury is a rare but well-known complication of regional anaesthesia and may arise from high pressure administration of local anaesthetic directly into nerve fascicles. Safe injection pressures ( This study measures injection pressures deemed ‘safe’ by experts and compares them with that of SAFIRA®. Methods Following IRB approval and with consent, ten skilled Operating Department Practitioners (ODPs) and ten Anaesthetists were recruited to inject 0.9% Saline at the ‘highest pressure they thought safe’ using a series of syringes (2.5 ml, 5 ml, 10 ml, 20 ml and 50 ml) attached to a Fluke 700GO6® pressure transducer (Fluke Corp, WA, USA). One hundred measurements were recorded. We then attached the SAFIRA® device (fitted with a 20 ml syringe) to the pressure transducer and measured the machine-limited pressure 100 times for comparison. Results In 21/100 manual injections, estimated ‘safe’ pressure was exceeded, with the highest measured at 44psi. Though the data was skewed by a few individuals, 50% of ODPs and 30% of Anaesthetists injected at pressures ≥20psi at least once (at all syringe sizes). Cut-off pressures from SAFIRA® were consistently below 20psi. Conclusions Practitioners best estimates of safe manual injection pressure is inaccurate. In contrast, a calibrated and engineered solution such as SAFIRA® does not require subjective user estimation.
Databáze: OpenAIRE