Is Perfusion Index an Indicator of Block Success in Ultrasound-guided Infraclavicular Brachial Plexus Block

Bakirkoy Dr. Sadi Konuk Research and Training Hospital30 enrolled

Overview

The infraclavicular nerve block, which is frequently preferred in upper extremity surgeries, provides additional advantages such as reduction in opioid consumption by providing analgesic effect in the postoperative period as welll. The success of peripheral nerve blocks is usually assessed by subjective feedback from the patient, and patient cooperation is needed. The aim of this study is to assess whether the perfusion index level, which can be measured noninvasively, can be a predictor of the infraclavicular block success.

Thirty patients who were operated on for carpal tunnel syndrome under infraclavicular brachial plexus block were included in our study. After the procedure, at 10-minute intervals, the sensory block was assessed by a pinprick test, and the motor block was assessed by the ability to flex the hand and the forearm. In addition, PI and skin temperature were measured 0-10-20-30 minutes after the block and at postoperative 2, 4, and 6 hours. 30 minutes after the measurements, the surgical procedure was allowed to begin in patients with successful block.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

Conditions

Carpal Tunnel Syndrome Perfusion Index

Interventions

Infraclavicular nerve blockPROCEDURE

The investigators performed an infraclavicular nerve block to the operated arm group to provide anesthesia.

Without nerve blockPROCEDURE

The upper extremity without block was assigned as the control group, and a comparison was made between the two upper extremities.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Ages of 18-75 * Patients who will diagnose with carpal tunnel syndrome by electroneuromyography (ENMG), and will undergo unilateral surgery under elective conditions * ASA I-II-III patients Exclusion Criteria: * Patients who will refuse this method * Neurological deficits, * Diabetes mellitus, * Local anesthetic allergy, * Morbidly obese, * Peripheral vascular disease, coronary artery disease, or coagulopathy

Outcomes

Primary Outcomes

Evaluation of whether perfusion index is a reliable and objective method to indicate block success

Perfusion index was measured up to 6 hours after the procedure.

Time frame: 6 hours postprocedurly

Secondary Outcomes

Determining of a cut-off value for PI and PI ratio for a successful block.

There may be changes in the cut-off value depending on the applied plexus area, local anesthesia, volume and concentration of LA and the applied assistive technique (ultrasound or nerve stimulator). For both this reason and due to the high variability in the PI values, the PI ratio was calculated to predict block success.

Time frame: Up to 6 hours after the procedure