A study to evaluate the change in perfusion index as an indicator of successful ultrasound-guided supraclavicular block

Bhardwaj, Mamta; Lal, J. H.; Malik, Aanchal; Bansal, Teena

doi:10.4103/ija.ija_553_21

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…Lal et al . [ 10 ] demonstrated that the mean PI is an objective and faster indicator for evaluating the success of USG-guided SCB. In the present study, the mean PI in the little finger was significantly less than the mean PI in the middle finger and thumb of the anaesthetised hand at 5, 10 and 15 min in the intertruncal group and at 5, 10, 15 and 20 min in the corner-pocket group.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intertruncal and corner-pocket approaches of ultrasound-guided supraclavicular block in terms of ulnar nerve blockade: A randomised controlled study

Trivedi,

Gupta,

Bhardwaj

et al. 2023

Indian Journal of Anaesthesia

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Background and Aims: The incidence of ulnar nerve sparing has declined with the corner-pocket approach of the supraclavicular block (SCB), however, it continues to persist. A recent technique of SCB, the intertruncal approach, separately blocks each trunk of the brachial plexus. Thus, we hypothesised that the intertruncal approach results in a complete ulnar nerve blockade. Methods: Eighty-eight patients were randomised to undergo SCB using an ultrasound (USG)-guided corner-pocket or intertruncal approach and were compared primarily regarding the complete sensory and motor blockade of the ulnar nerve and all four nerves (ulnar, radial, median and musculocutaneous nerves) at 15 min. Secondary objectives included time required for block performance, patient discomfort score, time to readiness for surgery and duration of sensory blockade of the ulnar nerve. Continous data were compared using an independent t-test, and categorical data were compared using the Chi-square test. Results: The proportion of participants with complete sensory (30/44 vs. 14/44, P < 0.001) and complete motor (22/44 vs. 7/44, P < 0.001) blocks in the ulnar nerve and all four nerves at 15 min was significantly higher in the intertruncal group. Block performance time and patient discomfort score were higher in the intertruncal group (P < 0.001). The total duration of sensory blockade in the ulnar nerve was more in the corner-pocket group (P < 0.001). Conclusion: USG-guided intertruncal approach is superior to the corner-pocket approach of SCB regarding a complete ulnar nerve blockade.

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Section: Discussionmentioning

confidence: 99%

Efficacy of intertruncal and corner-pocket approaches of ultrasound-guided supraclavicular block in terms of ulnar nerve blockade: A randomised controlled study

Trivedi,

Gupta,

Bhardwaj

et al. 2023

Indian Journal of Anaesthesia

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“…This volumetric change reflects on the AC amplitude (pulsatile) of the measurements. However, more than 90% of the PPG signals are from the quasi-DC portion (non-pulsatile) of the measurements [2].…”

Section: Introductionmentioning

confidence: 99%

Changes in morphology of multiwavelength photoplethysmography across and down major arteries in the forearm

Hsiao

McMurray

Branan

et al. 2023

Optical Diagnostics and Sensing XXIII: Toward Point-of-Care Diagnostics

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Photoplethysmography (PPG) is a non-invasive optical measurement that detects blood volume changes within the tissue from the skin's surface and is traditionally integrated into wearable technology to measure heart rate from the dorsal side of the wrist. The dorsal side of the wrist contains no major arteries, whereas the palmar side has two; the radial and ulnar arteries. To better understand the morphology of a PPG signal acquired along a major artery, this study investigated the change in PPG signals acquired from the distal to proximal locations of these two major arteries within the forearm. A multiwavelength (670nm, 770nm, 810nm, 850nm, 950nm) reflectance-based system was used to analyze the change in PPG morphology with the change in measurement location. Specifically, the sensor was placed into several zones down both arteries in the forearm to evaluate PPG waveform features. As the sensor traversed the arteries, changes in the morphology in each forearm zone were observed. Additionally, by using multiple wavelengths distinct waveforms were acquired from each penetration depth, as both arteries descend deeper away from the surface as you travel distal to proximal.

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“…The resolution or regression of the block occurs first in motor fibers, sensory, and then sympathetic [ 7 ]. A successful PNB changes the blood flow and vascular tone as a consequence of the sympathetic block [ 8 ]. The PI value represents the ratio of pulsatile and non-pulsatile blood flow in peripheral tissue, which is measured by pulse oximetry.…”

Section: Introductionmentioning

confidence: 99%

Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee Arthroplasty

Yun,

Kim,

Chung

2023

Life

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Background: The perfusion index (PI) is an objective method used to determine a successful nerve block. This study aimed to investigate the prognostic ability of the PI for a successful adductor canal nerve block (ACB) and suggest the optimal PI cut-off value for predicting a block. Methods: This study was a prospective observational study and enrolled a total of 39 patients. The patients were dichotomized into successful and inappropriate ACB groups according to the results of the sensation tests. The PI value, Pleth variability index (PVi) value, and heart rate were recorded one minute before the block, at the time of the block, and one to 30 min after the block at one-minute intervals. Delta (dPI), which was defined as the difference in PI value from the baseline (the value one minute before the block), was the primary outcome. The area under the receiver operating characteristic curve (AUROC) was calculated to determine the dPI prognostic accuracy and optimal cut-off value. Results: Successful ACB was achieved in 33 patients, while ACB was inappropriate in six patients. The dPI showed significant differences between the two groups under the time interval measured (p = 0.001). The dPI at 5 and 20 min showed good prognostic ability for a successful block, with optimal cut-off values of 0.33 (AUROC: 0.725, 95% CI 0.499–0.951) and 0.64 (AUROC: 0.813, 95% CI 0.599–1.000), respectively. Conclusions: The dPI is an effective predictor of successful ACB. The suggested dPI cut-off values at 5 and 20 min were below 0.33 and 0.64, respectively.

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A study to evaluate the change in perfusion index as an indicator of successful ultrasound-guided supraclavicular block

Cited by 7 publications

References 14 publications

Efficacy of intertruncal and corner-pocket approaches of ultrasound-guided supraclavicular block in terms of ulnar nerve blockade: A randomised controlled study

Efficacy of intertruncal and corner-pocket approaches of ultrasound-guided supraclavicular block in terms of ulnar nerve blockade: A randomised controlled study

Changes in morphology of multiwavelength photoplethysmography across and down major arteries in the forearm

Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee Arthroplasty

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