Does Continuous Injection Pressure Monitoring Reliably Detect Interfascial Planes in Regional Anesthesia? A Pilot...

Area of Science:

• Anesthesiology
• Biomedical Engineering
• Surgical Navigation

Background:

• Accurate interfascial plane localization is crucial for regional anesthesia.
• Ultrasound guidance can be challenging in certain patient populations.
• Injection pressure may vary with needle placement relative to anatomical structures.

Purpose of the Study:

• To evaluate continuous injection pressure monitoring for differentiating interfascial spaces.
• To assess the reliability of pressure monitoring in a porcine tissue model.
• To compare pressure characteristics between interfascial and intramuscular injections.

Main Methods:

• Utilized a custom pressure monitoring system with ultrasound guidance on porcine thighs.
• Measured continuous saline injection pressure using an infusion pump.
• Classified needle positions (intramuscular, fascial, interfascial) and analyzed pressure data statistically.

Main Results:

• Mean intramuscular pressure was significantly higher than interfascial pressure (p < 1 × 10⁻¹³).
• Interfascial injections showed lower pressure variability and an increasing pressure trend over time.
• Intramuscular injections exhibited a decreasing pressure trend over time.

Conclusions:

• Continuous pressure monitoring effectively distinguishes interfascial spaces from intramuscular locations.
• This method offers a potential real-time, objective tool for enhancing needle guidance in regional anesthesia.
• Further studies are needed to validate findings in cadaveric and clinical settings.