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Intravenous administration of drugs is frequently employed to achieve rapid and effective systemic effects. However, it is undesirable to administer drugs into the tissue as a result of extravasation of the intravenous cannula. Both the closed extremities to which the IV route is applied due to the surgical method to be applied make it difficult to access the vascular access during surgery and the use of pressurised instruments in the administration of drugs through the IV route makes the work of the anaesthetist difficult. In addition, patients cannot report their pain due to unconsciousness. In the operating theater and intensive care unit for anesthesia practice, induction, fluid therapy, nutrition, etc., although rare, difficulty in vascular access maintenance and drug extravasation cause serious complications in many procedures. This study aimed to emphasize the importance of perioperative anesthetic drug extravasation and its physiopathology by presenting current information. [ABSTRACT FROM AUTHOR]

Aims and objectives To estimate the prevalence of difficult venous access in complex patients with multimorbidity and to identify associated risk factors. Background In highly complex patients, factors like ageing, the need for frequent use of irritant medication and multiple venous catheterisations to complete treatment could contribute to exhaustion of venous access. Design A cross-sectional study was conducted. Methods 'Highly complex' patients ( n = 135) were recruited from March 2013-November 2013. The main study variable was the prevalence of difficult venous access, assessed using one of the following criteria: (1) a history of difficulties obtaining venous access based on more than two attempts to insert an intravenous line and (2) no visible or palpable veins. Other factors potentially associated with the risk of difficult access were also measured (age, gender and chronic illnesses). Univariate analysis was performed for each potential risk factor. Factors with p < 0·2 were then included in multivariable logistic regression analysis. Odds ratios were also calculated. Results The prevalence of difficult venous access was 59·3%. The univariate logistic regression analysis indicated that gender, a history of vascular access complications and osteoarticular disease were significantly associated with difficult venous access. The multivariable logistic regression showed that only gender was an independent risk factor and the odds ratios was 2·85. Conclusions The prevalence of difficult venous access is high in this population. Gender (female) is the only independent risk factor associated with this. Previous history of several attempts at catheter insertion is an important criterion in the assessment of difficult venous access. Relevance to clinical practice The prevalence of difficult venous access in complex patients is 59·3%. Significant risk factors include being female and a history of complications related to vascular access. [ABSTRACT FROM AUTHOR]