caa a22 4500 605509786 CHVBK 20210128100642.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s10877-015-9701-z doi (NATIONALLICENCE)springer-10.1007/s10877-015-9701-z An improvised pressure gauge for regional nerve blockade/anesthesia injections: an initial study [Elektronische Daten] [Jayaprakash Patil, Hari Ankireddy, Antony Wilkes, David Williams, Michael Lim] 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. Springer Science+Business Media New York, 2015 Boyle's law nationallicence Regional anesthesia nationallicence Injection pressure nationallicence Safety nationallicence Patil Jayaprakash Pinderfields Hospital, Mid-Yorkshire Hospitals NHS Trust, WF1 4DG, Wakefield, UK aut Ankireddy Hari Department of Anesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, CF14 4XN, Cardiff, Wales, UK aut Wilkes Antony Difficult Airway Society, 21 Portland Place, W1B 1PY, London, UK aut Williams David Welsh Centre for Burns, Morriston Hospital, SA6 6NL, Swansea, UK aut Lim Michael Department of Anesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, CF14 4XN, Cardiff, Wales, UK aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/6(2015-12-01), 673-679 1387-1307 29:6<673 2015 29 10877 https://doi.org/10.1007/s10877-015-9701-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-015-9701-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Patil Jayaprakash Pinderfields Hospital, Mid-Yorkshire Hospitals NHS Trust, WF1 4DG, Wakefield, UK aut NATIONALLICENCE 700 1- Ankireddy Hari Department of Anesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, CF14 4XN, Cardiff, Wales, UK aut NATIONALLICENCE 700 1- Wilkes Antony Difficult Airway Society, 21 Portland Place, W1B 1PY, London, UK aut NATIONALLICENCE 700 1- Williams David Welsh Centre for Burns, Morriston Hospital, SA6 6NL, Swansea, UK aut NATIONALLICENCE 700 1- Lim Michael Department of Anesthetics, Intensive Care and Pain Medicine, University Hospital of Wales, CF14 4XN, Cardiff, Wales, UK aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/6(2015-12-01), 673-679 1387-1307 29:6<673 2015 29 10877