Skin temperature changes after ultrasound-guided supra-inguinal fascia iliaca block: a prospective observational study

Abstract

Purpose Ultrasound-guided supra-inguinal fascia iliaca block (SFIB) is widely used as regional anesthesia of the hip and thigh. It is difficult to judge the blocking effect and the spreading local anesthesia. We hypothesize that the effect and spread of the block could be proven objectively by a rise in the temperature. In this prospective observational study, the broad regional rise in skin temperature of twenty patients who were scheduled for hip surgery was measured using an infrared thermographic camera at multiple intervals following ultrasound-guided SFIB. Methods Infrared thermographic imaging of skin temperature at the femoral, obturator, and lateral femoral cutaneous nerve sites was performed before and at 5-min intervals after ultrasound-guided SFIB for up to 15-min post-injection. The primary outcomes are skin surface temperature. Sensory block was assessed immediately after the final infrared thermographic image acquisition using the cold test. Results Compared to pre-injection baseline, temperature increased by 1.2 °C [95% confidence interval (CI) 0.4–2.0 °C] after 5 min, 1.2 °C (95% CI 0.4–2.0 °C) after 10 min, and 0.9 °C (95% CI 0.4–2.1°C) after 15 min. The cold test response was reduced in all cases at the femoral and lateral femoral cutaneous nerve sites and in 13 cases at the obturator nerve site. The sensitivity and specificity of the temperature increase to cold loss were 96% and 63%, respectively when we defined >0°C as the clinical threshold. Conclusions Successful SFIB significantly enhanced skin temperature at the hip and thigh in all cases, suggesting that infrared surface thermography can be used as an objective assessment tool for adequate analgesia. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN 000037866). Registered 31 August 2019.