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The effect of rate of injection on injection pressure profiles measured using in‐line and needle‐tip sensors: an in‐vitro study

Title: The effect of rate of injection on injection pressure profiles measured using in‐line and needle‐tip sensors: an in‐vitro study
Authors: Saporito, A.; Quadri, C.; Kloth, N.; Capdevila, X.
Source: Anaesthesia ; volume 74, issue 1, page 64-68 ; ISSN 0003-2409 1365-2044
Publisher Information: Wiley
Publication Year: 2018
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Summary Alongside ultrasonic visualisation, measurement of injection pressure is an effective tool for reducing the risk of intraneural injection during peripheral nerve block. The aim of this study was to compare injection pressure profiles when measured along the injection line with the pressure measured directly at the needle tip using different rates of injection. A syringe pump delivered a 5‐ml injection of saline into silicone gel at three different speeds (5 ml.min −1 , 10 ml.min −1 and 15 ml.min −1 ). Fibreoptic pressure sensors recorded real‐time pressure profiles of the injection pressure directly at the needle tip and along the injection line. A total of 15 injections were successfully performed, five for each injection rate, totalling 30 recorded pressure profiles. More rapid rates of injection caused peak pressure measured in‐line to increase, whereas pressure measured at the needle tip remained constant (mean ( SD ) pressure in‐line 30.76 (3.45) kP a vs. 72.25 (1.55) kP a and mean ( SD ) pressure at needle tip 19.92 (1.22) kP a vs. 20.93 (2.66) kP a at 5 ml.min −1 and 15 ml.min −1 , respectively). Injection pressure profiles showed that in‐line pressure measurement failed to record precise real‐time pressure changes occurring at the needle tip (mean (95% CI ) pressure difference 10.8 (6.98–14.70) kP a vs. 51.2 (47.52–54.89) kP a for in‐line and needle‐tip measures, respectively). We conclude that, in order to accurately monitor the true injection pressure generated, independent from operator and injection parameters, measurement at the needle tip is necessary, as injection pressure measured along the injection line is an unreliable surrogate.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/anae.14415
DOI: 10.1111/anae.14415/fullpdf
Availability: https://doi.org/10.1111/anae.14415; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fanae.14415; http://onlinelibrary.wiley.com/wol1/doi/10.1111/anae.14415/fullpdf
Rights: http://onlinelibrary.wiley.com/termsAndConditions#vor
Accession Number: edsbas.7ADDD7C8
Database: BASE