[Failure of an intravenous locoregional anesthesia in a hypertensive patient]

A case is reported of a congested arm occurring during intravenous regional anaesthesia with a double cuff tourniquet in a female elderly patient suffering from hypertension. The proximal cuff was apparently inflated adequately to 300 mmHg. Recent studies showed that the use of only the proximal tourniquet was associated with a risk of venous leakage. In elderly hypertensive patients, when intravenous regional anaesthesia was necessary, one would be justified in inflating the two cuffs before injection of the local anaesthetic.