Compartment Pressure Measurement Medication

  • Author: Liudvikas Jagminas, MD, FACEP; Chief Editor: Erik D Schraga, MD  more...
 
Updated: May 16, 2016
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

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Local Anesthetics, Amides

Class Summary

Local anesthetics block the initiation and conduction of nerve impulses.

Lidocaine (Xylocaine)

 

Lidocaine is an amide local anesthetic used in 1-2% concentration. The 1% preparation contains 10 mg of lidocaine for each 1 mL of solution; the 2% preparation contains 20 mg of lidocaine for each 1 mL of solution. Lidocaine inhibits depolarization of type C sensory neurons by blocking sodium channels.

To improve local anesthetic injection, cool the skin with ethyl chloride before injection. Use 1-2% without epinephrine to provide local anesthesia. Make sure the solution is at body temperature. Infiltrate very slowly to minimize the pain. Excessive deep infiltration may falsely elevate the compartment pressure reading. The time from administration to onset of action is 2-5 minutes, and the effect lasts for 1.5-2 hours.

Buffering the solution helps reduce the pain of local lidocaine injection. Sodium bicarbonate can be added to injectable lidocaine vials (1 part bicarbonate to 9 parts lidocaine) to produce buffered lidocaine. The shelf-life of buffered lidocaine is approximately 1 week at room temperature. All vials should be marked "buffered," labeled with the time and date, and signed by the person who created the buffered mixture.

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Contributor Information and Disclosures
Author

Liudvikas Jagminas, MD, FACEP Associate Professor and Vice-Chair, Department of Emergency Medicine, Yale University School of Medicine; Director of Clinical Operations, Department Emergency Medicine, Yale New Haven Hospital

Liudvikas Jagminas, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Trauma Society, Rhode Island Medical Society, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

Acknowledgements

Joseph U Becker, MD Fellow, Global Health and International Emergency Medicine, Stanford University

Joseph U Becker, MD is a member of the following medical societies: American College of Emergency Physicians, Emergency Medicine Residents Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Mary L Windle, PharmD, Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Acknowledgments

The author, Liudvikas Jagminas, MD, would like to thank his sons, Darius and Aleksus Jagminas, for contributing the drawings and photographs.

References
  1. Matsen FA. Compartmental syndromes. Grune & Stratton; 1980.

  2. Roed C, Bayer L, Lebech AM, Poulsen JB, Katzenstein T. [Compartment syndrome following adder bites]. Ugeskr Laeger. 2009 Jan 26. 171(5):327-8. [Medline].

  3. Von Volkmann R. Verletzungen und Krankheiten der Bewegungsorgane. Hanbude der Allgemeinen und Speciellen Chirurgie. 1872.

  4. Liu HL, Wong DS. Gluteal compartment syndrome after prolonged immobilisation. Asian J Surg. 2009 Apr. 32(2):123-6. [Medline].

  5. Frink M, Hildebrand F, Krettek C, Brand J, Hankemeier S. Compartment Syndrome of the Lower Leg and Foot. Clin Orthop Relat Res. 2009 May 27. [Medline].

  6. Olson SA, Glasgow RR. Acute compartment syndrome in lower extremity musculoskeletal trauma. J Am Acad Orthop Surg. 2005 Nov. 13(7):436-44. [Medline].

  7. Badhe S, Baiju D, Elliot R, Rowles J, Calthorpe D. The 'silent' compartment syndrome. Injury. 2009 Feb. 40(2):220-2. [Medline].

  8. Whitesides TE, Haney TC, Morimoto K, Harada H. Tissue pressure measurements as a determinant for the need of fasciotomy. Clin Orthop Relat Res. 1975 Nov-Dec. 43-51. [Medline].

  9. McQueen MM, Christie J, Court-Brown CM. Acute compartment syndrome in tibial diaphyseal fractures. J Bone Joint Surg Br. 1996 Jan. 78(1):95-8. [Medline].

  10. Simon RR, Koenigsknecht SJ. Emergency Orthopedics of the Extremities. 4th. New York: McGraw-Hill Publishing; 2001.

  11. Mubarak SJ, Owen CA, Hargens AR, Garetto LP, Akeson WH. Acute compartment syndromes: diagnosis and treatment with the aid of the wick catheter. J Bone Joint Surg Am. 1978 Dec. 60(8):1091-5. [Medline].

  12. Hargens AR, Schmidt DA, Evans KL, et al. Quantitation of skeletal-muscle necrosis in a model compartment syndrome. J Bone Joint Surg Am. 1981 Apr. 63(4):631-6. [Medline].

  13. Finkelstein JA, Hunter GA, Hu RW. Lower limb compartment syndrome: course after delayed fasciotomy. J Trauma. 1996 Mar. 40(3):342-4. [Medline].

  14. Katz LM, Nauriyal V, Nagaraj S, Finch A, Pearlstein K, Szymanowski A. Infrared imaging of trauma patients for detection of acute compartment syndrome of the leg. Crit Care Med. 2008 Jun. 36(6):1756-61. [Medline].

 
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Stryker.
Anterior compartment: pressure measurement.
Deep posterior compartment: pressure measurement.
Lateral compartment: pressure measurement.
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