A modification of the standard intravenous regional analgesia technique is described whereby excess local anaesthetic solution is removed from the veins of the isolated arm once analgesia has been established. This simple procedure was shown to reduce the incidence of oozing at the site of operation without affecting the quality of analgesia. Measurement of the quantity of local anaesthetic agent removed from the isolated arm 15 min after injection revealed that the amounts removed were small, indicating rapid uptake and binding in the tissues. This would imply that removal of excess local anaesthetic agent from the isolated arm after 15 min does not confer added safety as regards reducing the risk of leakage of agent into the general circulation in the event of cuff failure.

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Summary

Figure 1 Infant being treated with vertical-extension traction using the frame in an incubator. Figure 2 Traction frame constructed from thermoplastic material.