Skin Temperature After Interscalene Brachial Plexus Blockade

Hermanns, Henning; Braun, Sebastian; Werdehausen, Robert; Werner, Andreas; Lipfert, P.; Stevens, Markus F.

doi:10.1097/00115550-200711000-00005

Cited by 25 publications

(14 citation statements)

References 12 publications

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“…After axillary plexus block, skin temperature increased significantly at the distal forearm . Temperature measurement after interscalene brachial plexus block showed a significant increase distally, in dermatomes innervated by the median, ulnar, and radial nerve, while skin temperature at more proximal parts remained unchanged . Also, after distal single median nerve block at the wrist, skin temperature measured at the tip of the index finger increased significantly …”

Section: Thermoregulation During Peripheral Nerve Blocksmentioning

confidence: 91%

“…In contrast, distally at the skin innervated by the median, ulnar and radial nerves, skin temperature increased significantly after successful block while it did not after failed nerve block or on the contralateral side. Since a measurable rise in skin temperature preceded loss of sensory function in only 9% of cases and occurred at the same time in 35%, whereas in 56% of nerve blocks sensory impairment occurred first, the authors concluded that measurement of skin temperature is of limited clinical value to predict block success …”

Section: Skin Temperature As An Indicator Of Regional Anaesthesia Sucmentioning

confidence: 99%

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Assessment of skin temperature during regional anaesthesia—What the anaesthesiologist should know

Hermanns

Werdehausen

Hollmann

et al. 2018

Acta Anaesthesiol Scand

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Body temperature homeostasis is accurately regulated by complex feedback-driven neuronal mechanisms, which involve a multitude of thermoregulatory pathways. Thus, core temperature is constantly maintained within a narrow range. As one of the most effective regulatory systems skin temperature is dependent on skin blood flow. Skin blood flow in turn is highly dependent on sympathetic activity. Regional anaesthesia leads to blockade not only of somatosensory and motor nerve fibres but also of sympathetic fibres. As a consequence, vasoconstrictor tonic activity is abrogated and a vasodilation leads to an increase in skin blood flow and temperature. The aim of this review was to summarize the general physiology of thermoregulation and skin temperature as well as the alterations during regional anaesthesia. The main focus was the usefulness of measuring skin temperature as an indicator of regional anaesthesia success. According to the available literature, assessment of skin temperature can indeed serve to predict success of regional anaesthesia. Hence, it is important to realize that relevant and reliable temperature increase is only seen in the most distal body parts, ie fingers and toes. More proximally, temperature changes are frequently small and inconsistent, which means that assessment of block levels is not possible by temperature measurement. Furthermore, relevant skin temperature increases will only be observed in patients, which are initially vasoconstricted. In conclusion, measurement of skin temperature represents a reliable and feasible diagnostic tool to assess and predict the success or failure of regional anaesthesia procedures, especially in patients in which sensory testing is impossible.

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Section: Thermoregulation During Peripheral Nerve Blocksmentioning

confidence: 91%

Section: Skin Temperature As An Indicator Of Regional Anaesthesia Sucmentioning

confidence: 99%

Assessment of skin temperature during regional anaesthesia—What the anaesthesiologist should know

Hermanns

Werdehausen

Hollmann

et al. 2018

Acta Anaesthesiol Scand

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show abstract

“…Previous studies have shown that sympathetic nerve block of the upper limb leads to vasodilatation, increased blood flow and increased skin temperature in the hand and forearm . Consequently, changes in digit skin temperature (DsT) may be used as an objective surrogate measure to predict and determine peripheral block success . Previously, we have characterised the thermographic responses in the hand and forearm after individual blocks of the musculocutaneous, radial, ulnar and median nerves by use of infrared thermography .…”

mentioning

confidence: 99%

Ultrasound‐guided lateral infraclavicular block evaluated by infrared thermography and distal skin temperature

Asghar

Lundstrøm

Bjerregaard

et al. 2014

Acta Anaesthesiol Scand

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“…This seems only partially possible. [3,4,5,6] Research concerning the lower extremity is scarcer. [7,8] In the present study we observed the relationship between ultrasound guided subgluteal sciatic nerve blocks and skin temperature by infrared thermography in the lower extremity.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the success of sciatic nerve blockade by skin temperature measurement through infrared thermography

Haren¹,

Kadic²,

Driessen³

2014

Proceedings of the 2014 International Conference on Quantitative InfraRed Thermography

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We hypothesized that blocking the sciatic nerve with ropivacaine (local anesthetic) will lead to a (measurable) temperature increase in innervated skin, and that this will correlate with existing sensory block tests. Therefore, 18 individuals undergoing foot surgery were studied. Skin temperature was measured just before nerve blockade and every 10 minutes thereafter.Baseline skin temperatures showed a significant proximal to distal gradient. Thereafter, temperatures on increased significantly in the toes and foot. Pinprick correlates well to skin temperature, with an AUC in a Receiver Operating Curve of 85.9% (p<.001). This makes infrared skin temperature measuring a valuable test in determining block success.

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Skin Temperature After Interscalene Brachial Plexus Blockade

Cited by 25 publications

References 12 publications

Assessment of skin temperature during regional anaesthesia—What the anaesthesiologist should know

Assessment of skin temperature during regional anaesthesia—What the anaesthesiologist should know

Ultrasound‐guided lateral infraclavicular block evaluated by infrared thermography and distal skin temperature

Evaluation of the success of sciatic nerve blockade by skin temperature measurement through infrared thermography

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