Abstract
Intraneural introduction of local anesthetic belongs to the existing complications of peripheral nerves blockades. The damage of peripheral nerves is associated with the damaging effect of the injection needle and with the pressure caused by the introduction of local anesthetic. Purpose: Determine the pressure of the local anesthetic in fascial compartment of the sciatic nerve during his administration in the blockade of the sciatic nerve subgluteal access. Materials and Methods: Submitted blockade of the sciatic nerve subgluteal access in 22 patients with peripheral nerve electrostimulation under ultrasound guidance. To measure interstitial pressure system was used with the inclusion of a probe invasive blood pressure. Results: During the introduction of 1 ml in the fascial compartment of the sciatic nerve, the pressure of 0.77 psi (40 mmHg) was registered. In the course of the further introduction of local anesthetic up to 13 ml, the pressure did not alter validly (p > 0.05) and its average was 40 (35; 45) mmHg or 0.77 (0.68; 0.87) psi. This is the first study that has allowed to determine the pressure of local anesthetic in the fascial compartment of the sciatic nerve at the time of its introduction, the blockade of the sciatic nerve subgluteal access for the first time determined the probable maximum pressure intraneural injection of local anesthetic. The disadvantage of this study is that it is impossible to measure the pressure of administration over 5.8 psi (300 mmHg), and the lack of opportunity to assess the intraneural blood flow in the sciatic nerve during the creation of such pressure.
Highlights
Intraneural introduction of local anesthetic belongs to the existing complications of peripheral nerves blockadesHow to cite this paper: Kokhan, Z., Brukhnou, A., Marochkov, A. and Piacherski, V. (2014) Pressure of Local Anesthetic Solution While Performing Sciatic Nerve Blockade in Human Subgluteal Area
The performance characteristics of the monitor did not allow the measurement of the pressure higher than 5.8 psi (300 mmHg). In such cases the position of the injection needle was corrected and local anesthetic was introduced into the fascial compartment of the sciatic nerve
The authors did not measure the pressure in the fascial compartment of the sciatic nerve [3]
Summary
Intraneural introduction of local anesthetic belongs to the existing complications of peripheral nerves blockadesHow to cite this paper: Kokhan, Z., Brukhnou, A., Marochkov, A. and Piacherski, V. (2014) Pressure of Local Anesthetic Solution While Performing Sciatic Nerve Blockade in Human Subgluteal Area. Intraneural introduction of local anesthetic belongs to the existing complications of peripheral nerves blockades. How to cite this paper: Kokhan, Z., Brukhnou, A., Marochkov, A. and Piacherski, V. (2014) Pressure of Local Anesthetic Solution While Performing Sciatic Nerve Blockade in Human Subgluteal Area. The application of electrostimulation of peripheral nerves does not exclude intraneural introduction of local anesthetic [2]. The damage of peripheral nerves is associated with the damaging effect of the injection needle [3] and with the pressure caused by the introduction of local anesthetic. Dogs intraneural pressure was measured [3]. The data obtained prove that the nerve pressure higher than 25 psi involves neurologic disorders of the nerve anatomic structure and neurologic deficit
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