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Canadian Journal of Anesthesia, Vol 31, 364-367, Copyright © 1984 by Canadian Anesthesiologists' Society

Reports of Investigation: Venous Pressures in the Isolated Upper Limb during Saline Injection

BARRY A. FINEGAN MB FFARCS(I)1 and M. DAVID BUKHT MB FFARCS1

1 Department of Anaesthesia, Foothills Hospital at the University of Calgary, Calgary, Alberta

Address correspondence to: Dr. B.A. Finegan, Department of Anaesthesia, Foothills Hospital at the University of Calgary, 1403 29th St NW, Calgary, Alberta, T2N 2T9.

Venous pressure changes were assessed in the antecubital vein of an isolated arm during saline injection via an intravenous site on the dorsum of the hand. Although leak of contrast medium has been radiologically demonstrated in these circumstances, the compliance of the venous system of the isolated and exsanguinated limb has not been investigated. In five male and five female volunteers, after exsanguination and isolation of the upper limb, volumes of 40 ml or 60 ml of physiological saline were injected manually. The resultant pressure changes in the antecubital vein were continuously recorded during and after injection, until a steady state was reached.

Although peak pressures as high as 190 mmHg were noted early in the injection, venous pressures tended to plateau before the injection was complete and remained constant until the end of the injection. Resting venous pressures of 20 to 50 mmHg at the end of infusion occurred in all subjects. At no time did venous pressure approach cuff pressure. The mechanism of leak with an intact tourniquet is not explained, in our study, by the development of venous pressure in excess of tourniquet pressure in the isolated limb.

Key Words: ANAESTHETIC TECHNIQUES: regional, intravenous regional anaesthesia






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Copyright © 1984 by the Canadian Anesthesiologists' Society.