Injection Pressure Monitors for Nerve Blocks

[DrZzZz]

I occasionally watch some NYSORA videos on youtube. They often make some ridiculous claims about anesthesia practice and things being "standard of care." They posted one the other day where Dr. Hadzic claims that injection pressure monitors have become standard of care in "many" institutions for nerve blocks which made me laugh. I've never seen one anywhere I've been. I imagine they maybe exist in a handful of academic centers as a training tool. So, anyone out there ACTUALLY using these things? Or has seen or used one at some point in their career?

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[UscGhost]

I calibrate my thumb daily along with my machine check

 

[Lecithin5]

I just constantly remind my assisting nurse to push slowly. Nothing bothers me more than when a nurse blasts the local in, like it’s some sort of contest.

 

[hiyaman]

I have never used a pressure monitor nor have seen one for regional blocks. Have not had a nerve injury with using ultrasound. He also advocates for doing nerve stim, ultrasound, and pressure monitor. I think most of us just use the ultrasound plus paresthesia to prevent intraneural injections.

 

[BobLoblaw78]

I bought some to use with students and give them an idea. And to just try them out myself. You can always use the collapsible air bubble as well to determine your pressure. It was definitely neat to have around and use, but it is a novelty. I don't think I even used up the whole box of gauges that I ordered. They are about as necessary as the precut eye tape that you can buy.

 

[Volatile]

Injection pressure?? This is nonsense and is not standard of care. The more years I am removed from academics, the more I realize how much bull**** goes into publications. Take it all with a heavy dose of skepticism

 

[Maverikk]

Yep. At a high volume block center..after some hand nerve injuries which were blamed on the block…surprise they all happened to be with one surgeon who we was the only one we used the pressure monitor with, that’s about it’s only use

 

[nimbus]

Yep. At a high volume block center..after some hand nerve injuries which were blamed on the block…surprise they all happened to be with one surgeon who we was the only one we used the pressure monitor with, that’s about it’s only use

Not worth it to block that surgeon’s patients.

 

[caligas]

I aspirate, watch the needle/nerve/spread on ultrasound, watch the patient’s response, insure injection resistance is reasonable qualitatively…all while monitoring heart rate (generally have epi mixed into the local). I don’t have the mental capacity for another element to deal with.

 

[lunaire]

I've trained with it, used it some. It's got some evidence behind it. It's another tool you can choose to use or not use.

I think it's sensible to use something like this when you're doing landmark based blocks, or when teaching someone who sucks at ultrasound.

 

[pgg]

They're the DPE of PNBs.

 

[woopedazz]

They done any RCTs on what pressure gives the best spread while maintaining low complications? If not, what's the point of this number generator