title: Raynaud's phenomenon associated with the use of pneumatically powered surgical instruments.
abstract: Five patients developed symptoms of Raynaud's phenomenon and upper extremity paresthesias after 7-32 months of exposure to air-powered surgical instruments used for the harvest of bone for bone banks. Results of cold challenge plethysmography, nerve conduction studies, vibrotactile thresholds, and quantitative sensory testing were as follows: all patients had significant reproducible vasospasm with nondetectable finger systolic blood pressure (FSBP = 0) after local digital cooling; nerve conduction abnormalities included delayed median nerve sensory conduction (< 48 m/s) across 5 of 10 wrists; and no ulnar nerve abnormalities were detected. Vibrotactile thresholds were only modestly elevated, an unexpected outcome given the frequently recognized association between vibrotactile tests and nerve conduction studies. These abnormalities occurred with exposures to frequencies previously thought to be too high to be harmful to medical personnel.
authors.affiliation: Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, CT 06511.
authors.forename: M G
authors.initials: MG
authors.lastname: Cherniack
authors.forename: S
authors.initials: S
authors.lastname: Mohr
mesh_terms: D000328:Adult; D001794:Blood Pressure; D004867:Equipment Design; D005385:Fingers / Q000098:blood supply / Q000294:innervation / Q000503:physiopathology; D005500:Follow-Up Studies; D006282:Health Personnel; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D009431:Neural Conduction; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010991:Plethysmography; D011928:Raynaud Disease / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012684:Sensory Thresholds; D012881:Skin Temperature; D013525:Surgical Instruments / Q000009:adverse effects*; D013997:Time Factors; D014459:Ulnar Nerve / Q000503:physiopathology; D014732:Vibration / Q000009:adverse effects*