Lumbar Intervertebrai Disk Protrusion

Abstract

CORRESPONDENCEBROrNAH~~~~~~~~~~~~~~~~~~~~~~~~~M EDICAL JOURNAL blood pressure fell from 140/70 to 110/70. An intravenous blood transfusion was given throughout the operation, which lasted an hour, into a vein on the dorsum of the right hand which ran superficial to the space between the fourth and fifth metacarpals. At the end of the operation the fourth and fifth fingers were found to be cold and purple in colour, the tips of the fingers being dead white. Warmth was applied to the hand in the ward, and the drip continued for another hour, without improvement in the appearance of the two fingers. The drip was changed to a proximal vein in the other arm, with immediate return of circulation in the right hand.In Case I the patient's peripheral circulation was minimal, and the diminution caused by the cold blood entering the limb was sufficient to precipitate gangrene. Case 2 might have ended in the same way if the transfusion had been continued long enough and if the patient's general condition had not improved.