Evaluation of Prediction Effect of Perfusion Index for Supraclavicular Brachial Plexus Block in Children

Abstract

Background: Pulse perfusion index (PI) is a reflection of blood perfusion. It has been reported that PI can be used to evaluate the effect of nerve block, but currently it is mostly focused on awake adults. In pediatric general anesthesia, it has been reported that PI can evaluate the effect of sacral block, but there is a lack of relevant research on the effect of brachial plexus blocks (BPB).Methods/Design: This is a mono-center, prospective, single-blinded, randomized controlled trial (RCT). 104 children aged 1 month to 12 years who undergo upper limb surgery will be enrolled in this study. According to anesthesia induction and maintenance medication, they will be divided into propofol group and sevoflurane group. Record the PI values of the index finger and little finger on the blocked and non-blocked sides of supraclavicular brachial plexus block (SCB) in all children. First, analyze the two groups of patients with complete blockage respectively, and observe whether the PI values of the index finger and the little finger have the same changes by comparing the baseline values. Secondly, the cases of failed or partial block will be analyzed to understand the relationship between the PI values of the index and little fingers. Thirdly, a comparative analysis of nerve block cases in the sevoflurane and propofol groups will find that PI in what kind of general anesthesia can better judge the effect of SCB in children. So as to provide a theoretical basis for PI to estimate the effect of SCB under general anesthesia in children.Discussion: After sevoflurane or propofol administration, changes in PI after BPB may exist in different situations at different periods. PI values in the blocked and non-blocked sides may vary with the metabolism of anesthetics. The surgery time is about 1h or so and the effects of nerve block still exist, so the PI value changes on the blocking side and the contralateral side can basically rule out the influence of general anesthetics on the PI value. Trial registration: ClinicalTrials.gov NCT04216823. Registered on 15 July, 2020.