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.


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.

Contributor Information and Disclosures

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.


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.


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

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