Hand injuries caused by high pressure injection. Contribution of loco-regional anaesthesia

In a reported case of accidental high pressure injection of white spirit into a finger, the authors emphasise the great contribution of regional anaesthesia maintained from the initial trauma until the lesions are stable. Trauma to the hand caused by injection of paint or grease solvents results in tissue destruction and later necrosis and fibrosis. Secondary amputations are required in many cases. Regional anaesthesia of the stellate ganglion and brachial plexus produces analgesia and vasodilatation of peripheral arteries by inhibition of the sympathetic tone. This vasodilatation limits the necrotic process and promotes the supply of drugs to the injured tissues. Regional anaesthesia is of great benefit for surgical excision and avoids extended amputation.