Correlation between Two Monitoring Tools by Subjective and Objective Methods for Evaluation of Adequacy of Brachial Plexus Block: An Observational Study
- 1. Senior Resident, Department of Anaesthesiology, Govt. Medical College, Bhavnagar, Gujarat, India
- 2. Associate Professor, Department of Anaesthesiology, Govt. Medical College, Bhavnagar, Gujarat, India
- 3. Assistant Professor, Department of Anaesthesiology, Govt. Medical College, Bhavnagar, Gujarat, India
Description
Introduction: Supraclavicular block provides adequate anaesthesia and analgesia but lacking objective methods of assessment, so in this study PI index using pulse oximetry was used to assess the adequacy of block. Methods: The study was conducted on 100 patients undergoing elective or emergency orthopaedic procedures under brachial plexus nerve block. After local anaesthetic injection, sensory and motor block success was assessed every 5min by traditional pinprick and Modified Bromage Scale methods respectively. The PI was recorded at baseline and at every 5 minutes till 30 minutes after anaesthetic injection in both blocked and non-blocked limbs. The PI ratio was calculated as the PI after 5min divided by the PI at the baseline. Result: The PI was higher in the blocked limb at all time points except baseline and this was paralleled by a higher PI ratio compared with the unblocked limb. At the time when complete sensory block achieved, the correlation Pearson coefficient of PI was 0.979 (p < 0.001) and for motor block it was 0.932 (p – 0.002), which shows positive correlation between both the assessment methods. Conclusion: PI and PI ratio are positively correlated with the traditional subjective methods of assessment of block adequacy. So, it can be a good alternative in uncooperative, sedated patients.
Abstract (English)
Introduction: Supraclavicular block provides adequate anaesthesia and analgesia but lacking objective methods of assessment, so in this study PI index using pulse oximetry was used to assess the adequacy of block. Methods: The study was conducted on 100 patients undergoing elective or emergency orthopaedic procedures under brachial plexus nerve block. After local anaesthetic injection, sensory and motor block success was assessed every 5min by traditional pinprick and Modified Bromage Scale methods respectively. The PI was recorded at baseline and at every 5 minutes till 30 minutes after anaesthetic injection in both blocked and non-blocked limbs. The PI ratio was calculated as the PI after 5min divided by the PI at the baseline. Result: The PI was higher in the blocked limb at all time points except baseline and this was paralleled by a higher PI ratio compared with the unblocked limb. At the time when complete sensory block achieved, the correlation Pearson coefficient of PI was 0.979 (p < 0.001) and for motor block it was 0.932 (p – 0.002), which shows positive correlation between both the assessment methods. Conclusion: PI and PI ratio are positively correlated with the traditional subjective methods of assessment of block adequacy. So, it can be a good alternative in uncooperative, sedated patients.
Files
IJTPR,Vol12,Issue8,Article6.pdf
Files
(385.8 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:a90e33622e31cacd1a2e072d28a497ba
|
385.8 kB | Preview Download |
Additional details
Dates
- Accepted
-
2022-08-06
Software
References
- 1. Faraj W. Abdallah et al. The definition of block "success" in the contemporary literature: are we speaking the same language? Reg Anesth Pain Med.2012 Sep-Oct;37(5)545-53 2. Curatolo M, Petersen-Felix S, ArendtNielsen L, Sensory assessment of regional anaesthesia in humans: a review of methods and applications. Anaesthesiology 2000; 93:1517-30 3. Abdelnasser B. Abdelhamid A. Elsonbaty A. Hasanin A. rady., Predicting successful supraclavicular brachial plexus block using pulse oximeter perfusion index, BJA: British Journal of Anaesthesia, Volume 119, Issue 2, August 2017, 276-280 4. Yamazaki H, Nashiyama J, Suzuki T. Use of perfusion index from pulse oximetry to determine efficacy of stellate ganglion block. Local Reg Anesth. 2012;5:9-14 5. Zifeng Xu, Jianhai Zhang, Jijian Zheng. Assessment of pulse oximeter perfusion index in pediatric caudal block under basal ketamine anaesthesia. Scientific world journal;2013:sep 19 6. Park SG, Lee OH, Park Y-H, et al. The changes of non-invasive hemoglobin and perfusion index of Pulse CO-Oximetry during induction of general anesthesia. Korean J Anesthesiol2015;68: 352–7 7. Ginosar Y, Weiniger CF, Meroz Y, et al. Pulse oximeter perfusion index as an early indicator of sympathectomy after epidural anesthesia. Acta Anaesthesiol Scand 2009; 53:1018–26 8. Klodell CT, Lobato EB, Willert JL, Gravenstein N. Oximetryderived perfusion index for intraoperative identification of successful thoracic sympathectomy. Ann Thorac Surg 2005;80:467–70 9. Rasmy I, Mohamed H, Nabil N, et al. Evaluation of perfusion index as a predictor of vasopressor requirement in patients with severe sepsis. Shock 2015; 44:554–9 10. Hasanin A, Mohamed SA, El-Adawy A. Evaluation of perfusion index as a tool for pain assessment in critically ill patients. J Clin Monit Comput 2016. [Epub ahead of print] Doi: 10.1007/s10877-016-9936-3 11. Sebastiani A, Philippi L, Boe hme S, et al. Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters. Can J Anaesth 2012; 59: 1095–101.