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Claudio, R., Hadzic, A., Shin, H., Vloka, J.D., Castro, J., Koscielniak-Nielsen, Z., Thys, D.M. and Santos, A.C. (2004) Injection Pressures by Anesthesiologists during Simulated Peripheral Nerve Block. Regional Anesthesia and Pain Medicine Journal, 29, 201-205.

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• TITLE: Pressure of Local Anesthetic Solution While Performing Sciatic Nerve Blockade in Human Subgluteal Area

  AUTHORS: Zakhar Kokhan, Andrei Brukhnou, Aliaksei Marochkov, Valery Piacherski

  KEYWORDS: Peripheral Blockade, Sciatic Nerve, Pressure of the Local Anestnetiс, Ultrasound Guidance

  JOURNAL NAME: Open Journal of Anesthesiology, Vol.4 No.11, November 11, 2014

  ABSTRACT: Intraneural introduction of local anesthetic belongs to the existing complications of peripheral nerves blockades. The damage of peripheral nerves is associated with the damaging effect of the injection needle and with the pressure caused by the introduction of local anesthetic. Purpose: Determine the pressure of the local anesthetic in fascial compartment of the sciatic nerve during his administration in the blockade of the sciatic nerve subgluteal access. Materials and Methods: Submitted blockade of the sciatic nerve subgluteal access in 22 patients with peripheral nerve electrostimulation under ultrasound guidance. To measure interstitial pressure system was used with the inclusion of a probe invasive blood pressure. Results: During the introduction of 1 ml in the fascial compartment of the sciatic nerve, the pressure of 0.77 psi (40 mmHg) was registered. In the course of the further introduction of local anesthetic up to 13 ml, the pressure did not alter validly (p > 0.05) and its average was 40 (35; 45) mmHg or 0.77 (0.68; 0.87) psi. This is the first study that has allowed to determine the pressure of local anesthetic in the fascial compartment of the sciatic nerve at the time of its introduction, the blockade of the sciatic nerve subgluteal access for the first time determined the probable maximum pressure intraneural injection of local anesthetic. The disadvantage of this study is that it is impossible to measure the pressure of administration over 5.8 psi (300 mmHg), and the lack of opportunity to assess the intraneural blood flow in the sciatic nerve during the creation of such pressure.