Injection pressure as a marker of intraneural injection in procedures of peripheral nerves blockade.

Abstract

The blockade of peripheral nerves carries a certain risk of unwanted complications, which can follow after unintentional intraneural injection of a local anesthetic. Up till today, the research of measuring injection pressure has been based on animal models, even though the histological structure of periphery nerve is different for animal and human population, so the application pressure which presages intraneural injection in human population is still unknown. As material in performing this study there have been used 12 Wistar rats and 12 delivered stillborns. After bilateral access to the median nerve, we applied 3 ml of 2% lidocaine with epinephrine, with the help of automatic syringe charger. The needle was at first placed perineural on one side, and then intraneural on the other side of both examination groups. During every application the pressure values were monitored using the manometer, and then they were analyzed by special software program BioBench. All perineural injections resulted with the pressure < or = 27.92 kPa, while the majority of intraneural injections were combined with the injection pressure > or = 69.8 kPa. The difference between intraneural and perineural injection pressures for the two different examination groups (rats and delivered stillborns) was not statistically significant (P>0.05). As prevention from intraneural injections today are in use two methods: the method of causing paresthesia or the method of using the peripheral nerve stimulator. However the nerve injury can still occur, independent from the technique used. If our results are used in clinical practice on human population, than the high injection pressure could be the marker of intraneural lodging of a needle.

• Authors: Ilvana Vucković, Faruk Dilberović, Amela Kulenović, Kucuk-Alija Divanović, Alma Voljevica, Eldan Kapur
• Journal: Bosnian journal of basic medical sciences (Bosn J Basic Med Sci) Vol. 6 Issue 4 Pg. 5-12 (Nov 2006) ISSN: 1512-8601 [Print] Bosnia and Herzegovina
• PMID: 17177640 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anesthetics, Local

Topics

• Anesthetics, Local (administration & dosage, adverse effects)
• Animals
• Data Interpretation, Statistical
• Humans
• Infant, Newborn
• Injections
• Manometry
• Median Nerve (physiology)
• Nerve Block (adverse effects)
• Peripheral Nerves
• Pressure
• Rats
• Rats, Wistar
• Stillbirth