An improvised pressure gauge for regional nerve blockade/anesthesia injections: an initial study

Verfasser / Beitragende:
[Jayaprakash Patil, Hari Ankireddy, Antony Wilkes, David Williams, Michael Lim]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Clinical Monitoring and Computing, 29/6(2015-12-01), 673-679
Format:
Artikel (online)
ID: 605509786
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024 7 0 |a 10.1007/s10877-015-9701-z  |2 doi 
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245 0 3 |a An improvised pressure gauge for regional nerve blockade/anesthesia injections: an initial study  |h [Elektronische Daten]  |c [Jayaprakash Patil, Hari Ankireddy, Antony Wilkes, David Williams, Michael Lim] 
520 3 |a High injection pressure is one of the warning signs of intraneural injection, with animal models suggesting pressures higher than 69 or 176kPa as high risk, and is normally detected subjectively and inaccurately. We describe a system improvised from common clinical components that uses Boyle's law to objectively measure injection pressure. The objectives of the study were to (1) Validate our improvised pressure gauge (IPG) by comparing the injection pressure as calculated by Boyle's law against the measured pressure and (2) Use the IPG to measure the range of injection pressures by two groups of anesthetic professionals using the "syringe feel” technique. Our IPG system consists of an extended 1ml syringe attached to a 3-way stopcock, inserted between the syringe containing the local anesthetic injectate and the needle. The IPG was validated against a pressure calibration reference. 20 anesthesiologists and 20 anesthetic assistants were recruited to apply pressure to the 20ml syringe in vitro while blinded to the attached IPG. The pressures were measured on three separate occasions for each participant. There was good agreement (<8percent difference) between the measured and theoretical pressure values. Anesthesiologists exceeded the threshold of 69kPa in 18 of a total of 60 attempts whereas anesthetic assistants exceeded the threshold in 30 attempts out of 60 attempts. Anesthetic assistants exerted a higher overall pressure of 80kPa compared to 51kPa for anesthesiologists—this was statistically significant (p=0.027). Our improvised system is easily and rapidly assembled from common clinical equipment and shows promise as a monitor for inadvertent intraneural injection. 
540 |a Springer Science+Business Media New York, 2015 
690 7 |a Boyle's law  |2 nationallicence 
690 7 |a Regional anesthesia  |2 nationallicence 
690 7 |a Injection pressure  |2 nationallicence 
690 7 |a Safety  |2 nationallicence 
700 1 |a Patil  |D Jayaprakash  |u Pinderfields Hospital, Mid-Yorkshire Hospitals NHS Trust, WF1 4DG, Wakefield, UK  |4 aut 
700 1 |a Ankireddy  |D Hari  |u Department of Anesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, CF14 4XN, Cardiff, Wales, UK  |4 aut 
700 1 |a Wilkes  |D Antony  |u Difficult Airway Society, 21 Portland Place, W1B 1PY, London, UK  |4 aut 
700 1 |a Williams  |D David  |u Welsh Centre for Burns, Morriston Hospital, SA6 6NL, Swansea, UK  |4 aut 
700 1 |a Lim  |D Michael  |u Department of Anesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, CF14 4XN, Cardiff, Wales, UK  |4 aut 
773 0 |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/6(2015-12-01), 673-679  |x 1387-1307  |q 29:6<673  |1 2015  |2 29  |o 10877 
856 4 0 |u https://doi.org/10.1007/s10877-015-9701-z  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s10877-015-9701-z  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Patil  |D Jayaprakash  |u Pinderfields Hospital, Mid-Yorkshire Hospitals NHS Trust, WF1 4DG, Wakefield, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ankireddy  |D Hari  |u Department of Anesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, CF14 4XN, Cardiff, Wales, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Wilkes  |D Antony  |u Difficult Airway Society, 21 Portland Place, W1B 1PY, London, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Williams  |D David  |u Welsh Centre for Burns, Morriston Hospital, SA6 6NL, Swansea, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lim  |D Michael  |u Department of Anesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, CF14 4XN, Cardiff, Wales, UK  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/6(2015-12-01), 673-679  |x 1387-1307  |q 29:6<673  |1 2015  |2 29  |o 10877