Pressure monitoring: the evidence so far

Publication date: Available online 5 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Milly Rambhia, Jeff GadsdenAbstractNerve injury is a relatively rare, but devastating complication of peripheral nerve blockade (PNB). Monitoring injection pressure during PNB is one method advocated to prevent injury by detecting needle tip placement in a non-compliant position (intraneural or abutting the epineurium). Animal studies show that gross neural damage and clinical injury are associated with injection pressures exceeding 15-20 psi. In contrast, pressures <15 psi are associated with an extraneural needle tip position and no histologic or clinical injury. Injection pressure monitoring has been shown to prevent injection against the brachial plexus roots or femoral nerve during peripheral nerve block. Multiple methods are available to monitor injection pressure, and most are inexpensive and easy to use. Large scale registry database or pragmatic trials are indicated to show that injection pressure monitoring reduces injury in a patient setting.
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research