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Injection pressures measuring for a safe peripheral nerve block.

Massimiliano Carassiti1, Aurelio De Filippis2, Paola Palermo2

  • 1Department of Anesthesia and Intensive Care Medicine, Campus Bio-Medico University, Rome, Italy - m.carassiti@unicampus.it.

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|May 25, 2019
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Summary
This summary is machine-generated.

Injection pressure monitoring during peripheral nerve blockade (PNB) can enhance safety. Studies suggest pressures below 15 psi are acceptable for perineural injections, reducing nerve damage risk.

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Area of Science:

  • Anesthesiology
  • Neurology
  • Medical Devices

Background:

  • Peripheral nerve blockade (PNB) relies on ultrasound and nerve stimulators for precision and safety.
  • Injection pressure monitoring during PNB may further improve procedural safety.

Purpose of the Study:

  • To review and analyze injection pressures recorded during PNB in animal and human studies.
  • To identify the relationship between injection pressure and the risk of nerve damage.

Main Methods:

  • Systematic review of PubMed/MEDLINE database for English articles published between January 2004 and November 2018.
  • Selection of 15 original papers, excluding reviews, case reports, and correspondence.
  • Classification of studies based on models used: animals, humans, and in vitro.

Main Results:

  • Intraneural injections were associated with lower pressures compared to perineural injections.
  • High injection pressures at the needle tip correlate with an increased risk of nerve damage.
  • A threshold of 15 psi is suggested as an acceptable pressure for safe perineural injections during PNB.

Conclusions:

  • While a definitive cut-off pressure is not established, 15 psi appears to be a safe threshold for perineural injections.
  • Further research is needed to validate pressure monitoring for PNB safety.
  • Future pressure monitoring systems should be non-invasive and not impede anesthetist workflow, potentially enabling reduced anesthetic volumes.