Perfusion Index and ultrasonography in the evaluation of infraclavicular block

Bereket, Mehmet M; Aydın, Bengü Gülhan; Küçükosman, Gamze; Pişkin, Özcan; Okyay, Rahşan Dilek; Ayoğlu, Ferruh Niyazi; Ayoğlu, Hilal

doi:10.23736/s0375-9393.18.13046-x

Cited by 12 publications

(9 citation statements)

References 19 publications

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“…Regional haemodynamic parameters were measured by pulsed-wave Doppler (PWD) ultrasound (M7 super, Mindray Medical International, China) with a 12–4 MHz linear array transducer. 3 6 We defined the location of the anterior tibial artery (ATA) as 1 cm proximal to the extensor retinaculum ( figure 2A ). The location of the posterior tibial artery (PTA) was defined to be halfway between the posterior border of the medial malleolus and the Achilles tendon ( figure 2B ).…”

Section: Methodsmentioning

confidence: 99%

“…At each time point, we obtained US and PI data before conducting the pinprick sensory tests. We performed the pinprick sensory tests with a 24-gauge blunt needle on the skin innervated by the sciatic nerve and evaluated the findings using the Hollmen scale 3 ((0) normal transmission using the pinprick test; (1) needle sensed less than the contralateral extremity; (2) feeling the needle as a blunt object; (3) loss of tactile sense). We also recorded the non-invasive BP and HR at each time point.…”

Section: Methodsmentioning

confidence: 99%

“… 1 2 Therefore, non-invasive, objective measures are needed for an accurate determination of success. 3 However, most of the studies evaluating objective metrics (such as perfusion index (PI)) on regional blocks were about brachial plexus block (BPB), 4–8 rather than on sciatic nerve block (SNB). Due to blockade latency 9 and varied success rates of 71% and 97%, 10 11 there is a need to investigate novel SNB assessments.…”

Section: Introductionmentioning

confidence: 99%

“…This can be particularly challenging in elderly patients with neurodegenerative diseases, in children, and in those who have neuropsychiatric disorders, or when there is a language barrier 1 2. Therefore, non-invasive, objective measures are needed for an accurate determination of success 3. However, most of the studies evaluating objective metrics (such as perfusion index (PI)) on regional blocks were about brachial plexus block (BPB),4–8 rather than on sciatic nerve block (SNB).…”

Section: Introductionmentioning

confidence: 99%

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Regional haemodynamic variables and perfusion index in the evaluation of sciatic nerve block: a prospective observational trial

Jiang

et al. 2022

BMJ Open

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ObjectiveWe determined whether regional haemodynamics and perfusion index (PI) could be reliable indicators of a successful sciatic nerve block (SNB).DesignProspective observational trial.SettingA tertiary teaching hospital in China from April 2020 to August 2020.ParticipantsWe assessed 79 patients for eligibility to participate in this study. Nine patients were excluded for not meeting our inclusion criteria, and three patients were excluded due to missing measurements at all time points.InterventionsThe patients underwent SNB. Pulsed-wave Doppler and PI measurements were performed.Primary and secondary outcome measuresThe primary outcome measure was the diagnostic power of regional haemodynamic change and PI to predict successful SNB. The secondary outcome measure was the effect of SNB on the regional haemodynamics and PI in the lower extremity.ResultsWe assessed 79 patients in this study and 67 patients available for the final analysis. The SNB was successful in 59 patients and failed in eight patients. There were no significant differences in demographic characteristics between the patients with successful and failed SNB. Starting from 10 min after SNB, the peak systolic velocity (PSV), end-diastolic velocity, time-averaged maximum velocity and time-averaged mean velocity of the anterior tibial artery and posterior tibial artery of patients in the successful SNB group were significantly higher than those in the failed SNB group (p<0.05). The PSV percentage increase at 10 min after SNB has great potential to predict the block success. The area under the receiver operating characteristic curve (AUC) values were 0.893 (95% CI 0.7809 to 1.000) and 0.880 (95% CI 0.7901 to 0.9699). The corresponding cut-off values were 19.22 and 35.88, respectively. The PI increased during 5–45 min intervals in patients with successful SNB. The AUC for the PI percentage increases at 10 min after SNB was 0.853 (95% CI 0.7035 to 1.000), with a cut-off value of 93.09.ConclusionThe regional haemodynamic variables, PSV and PI in particular, can be used as alternative indicators for clinicians to evaluate the success of SNB objectively and early.Trial registration numberChiCTR2000030772.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Regional haemodynamic variables and perfusion index in the evaluation of sciatic nerve block: a prospective observational trial

Jiang

et al. 2022

BMJ Open

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“…in 40 patients who underwent an infraclavicular block, they monitored the Perfusion index (Pi) and regional hemodynamic parameters in the ipsilateral limb. 67 ten minutes after the block execution, Doppler parameters were valid to confirm its success or failure due to the sympathectomy effect. Needles visibility during ultrasound-guided peripheral nerve blocks is vital for procedural success and prevention of possible side effects and complications.…”

Section: Regional Anesthesiamentioning

confidence: 99%