A simple method of simultaneously administering intravenous fluids in the forearm with bilateral upper extremity tourniquets

Abstract

When simultaneous or sequential upper extremity surgery is done with pneumatic tourniquets on both arms, the use of lower extremities for venous access is inconvenient as it is far removed from the head where the anesthesia team works and access to the lower ex­ tremity is often obscured by the draping. We used an intravenous catheter inserted at the elbow or at the proximal forearm with the tip of the catheter advanced proximally to the subsequently applied tourniquet cuff in the upper arm. Tourniquet pressure up to 300 mm of mercury did not occlude the catheter and allowed ve­ nous access for intravenous administration of fluids and medications. Fifty patients had bilateral upper extremity surgery because they did not want to be subjected to anesthesia twice. All operations were done under general anes­ thesia. A size 16, 30-centimeter subclavian jugular catheter* was inserted into a vein in the proximal From the Departments of Hand Surgery and Anesthesiology, Maimonides Medical Center, Brooklyn, N.Y.