Intravenous regional analgesia. The danger of the congested arm and the value of occlusion pressure.

摘要: Two cases are described in which congestion of the arm occurred during intravenous regional analgesia. One case exhibited signs serious local anaesthetic toxicity, while a significant plasma bupivacaine level was demonstrated other. In study volunteer, leakage contrast medium past cuff radiologically only when produced. The Hoyle double apparatus has narrow cuffs producing less tissue compression than standard blood pressure inflated to same pressure. It may sometimes not occlude brachial artery based on systolic arterial measured with and then result. Increases occurring procedure can also lead arm. Congestion increase risk agent leaking tourniquet into systemic circulation. Recommendations made about choice gauge prevention