Lower Extremity Near-infrared Spectroscopy After Popliteal Block For Orthopaedic Foot Surgery

Abstract

Background:Noninvasive measurement of cutaneous tissue oxygenation using near-infrared spectroscopy (NIRS) has become common in peri-operative care. Following institution of peripheral nerve blocks, neurovascular alterations in the blocked region have been described.Objective:The primary aim of this study encompassed the assessment of the influence of a popliteal block on changes in regional oxygen saturation (SrO2), and the location of most prominent changes.Method:We conducted a prospective randomised controlled trial. Hundred twenty patients who received a popliteal block for foot surgery were included. Popliteal block was performed under echographic guidance. The patients were randomized in 3 groups according to the location of the SrO2 electrodes on the legs. Bilateral SrO2 measurements were performed simultaneously. SrO2 in the operated leg and in the control leg was measured at baseline and 1, 5, 10, 15, and 30 minutes after the perineural injection. We quantified the evolution in SrO2 by calculating over time the differences in SrO2 values between the operated and control leg (=ΔSrO2).Results:At 30 minutes, ΔSrO2 increased significantly (p<0.05) at the plantar side of the foot (11.3% ± 2.9%), above the ankle (4.9% ± 1.3%) and the popliteal fossa (3.6% ± 1.2%).Conclusion:At 30 minutes after institution of the popliteal block, ΔSrO2 was most prominent at the plantar side of the foot as compared with measurement performed above the ankle or under the knee.

Tissue Oxygen Saturation Change on Upper Extremities After Ultrasound-Guided Infraclavicular Brachial Plexus Blockade; Prospective Observational Study

“…Literature reviews indicate that only a few studies have evaluated the efficacy of NIRS monitoring in the induction of peripheral nerve blocks [4,12,13]. Unlike these studies, our study is the first comprehensive study using NIRS in the administration of infraclavicular nerve block, which is a type of upper extremity peripheral nerve block.…”

Comparative of the Effectiveness of Different Objective Method for Infraclavicular Brachial Plexus Block Success; Which One of Them is A Reliable and Early Indicator?

“…14 Although there have been publications about the use of StO2 in evaluating peripheral nerve block success, there are few studies in the literature regarding its use to measure the success of peripheral block. 9,[15][16][17][18] In the first study, which showed that NIRS can capture the increase in local tissue perfusion occurring after the block, a 15% increase in oxygen saturation was detected in the limb that was performed block procedure after the brachial plexus blockage (interscalene, supraclavicular, infraclavicular or axillary). Significant increases in StO2 values were observed within 5 min after the completion of the block, which occurred before the patients perceived sensory and motor loss.…”

Comparison of the efficacy of five different objective methods to evaluate the success of infraclavicular block; Which one of them is a reliable and early indicator?

“…[14] Although there have been publications about the use of StO 2 in evaluating peripheral nerve block success, there are few studies in the literature regarding its use to measure the success of peripheral block. [8,9,[15][16][17] In the first study, which showed that NIRS can capture the increase in local tissue perfusion occurring after the block, a 15% increase in oxygen saturation was detected in the limb that was performed block procedure after the brachial plexus blockage (interscalene, supraclavicular, infraclavicular, or axillary). Significant increases in StO 2 values were observed within 5 min after the completion of the block, which occurred before the patients perceived sensory and motor loss.…”