Evaluation of a fiber-optic technique for recording intramuscular pressure in the human leg.

Abstract

To evaluate a forward-sensing fiber-optic pressure technique for recording of intramuscular pressure (IMP) in the human leg and investigate factors that may influence IMP measurements used in diagnosing compartment syndromes. IMP in the tibialis anterior muscle was recorded simultaneously by a fiber-optic technique and needle-injection technique in 12 legs of 7 healthy subjects. Both measurement catheters were placed in parallel with the muscle fibers to the same depth, as verified by sonography. IMP recordings were performed at rest before, during and after applying a model of abnormally elevated IMP (simulated compartment syndrome). IMP was elevated by venous obstruction induced by a thigh tourniquet of a casted leg. IMP was also measured during injections of 0.1ml of saline into the muscle through the catheters. IMP at baseline was 5.1 (SD=2.6) mmHg measured with the fiber-optic technique and 7.1 (SD=2.5) mmHg with the needle-injection technique (p<0.001). It increased to 48.5 (SD=6.9) mmHg and 47.6 (SD=6.6) mmHg respectively, during simulated compartment syndrome. IMP increased significantly following injection of 0.1ml of saline, measured by both techniques. It remained increased 1min after injection. The fiber-optic technique was able to record pulse-synchronous IMP oscillations. The fiber-optic technique may be used for IMP measurements in a muscle with both normal and abnormally elevated IMP. It has good dynamic properties allowing for measurement of IMP oscillations. Saline injection used with needle-injection systems to ensure catheter patency compromises IMP readings at least one minute after injection.