ABSTRACT
Continuous infusion of a local anesthetic by means of a percutaneous forearm catheter
and an infusion pump was studied for its utility in achieving sympathetic blockade
following replantation and revascularization of the digits. The efficacy of the technique
was demonstrated by cold stress testing. When the technique was used in 55 patients
who underwent digital replantation or revascularization, 53 of 57 replanted digits
(93 percent) and 25 of 26 revascularized digits (96 percent) survived. The analgesia
obtained from the nerve block benefited patient comfort during hospitalization. and
normal sensibility in the uninjured digits returned promptly after discontinuing the
anesthetic in all but one patient. The reported study indicates that continuous peripheral
nerve block by means of an indwelling forearm catheter is a safe and effective adjunct
in preventing neurogenically-mediated vasospasm.
