Noninvasive tissue oxygen saturation determined by near‐infrared spectroscopy following peripheral nerve block

Tighe, Patrick J.; Elliott, Clint E.; Lucas, Stephen D.; Boezaart, André P.

doi:10.1111/j.1399-6576.2011.02533.x

Cited by 25 publications

(25 citation statements)

References 23 publications

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“…Therefore, PNB may enhance peripheral inflammation through the blockade of Nav1.8 following the incision, which is likely associated with infection. Another possibility is that the increase in tissue oxygen saturation by PNB 19 contributes to the increased infiltration of immune cells at the incision site. It was reported that the elevation of oxygen saturation by increased peripheral perfusion is correlated with the incidence of surgical site infection, 20 and promoted the migration of neutrophils through the induction of ICAM-1 expression on endothelial cells.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Nerve Block Facilitates Acute Inflammatory Responses Induced by Surgical Incision in Mice

Yamada

Hasegawa-Moriyama²,

Kurimoto

et al. 2016

Regional Anesthesia and Pain Medicine

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Section: Discussionmentioning

confidence: 99%

Peripheral Nerve Block Facilitates Acute Inflammatory Responses Induced by Surgical Incision in Mice

Yamada

Hasegawa-Moriyama²,

Kurimoto

et al. 2016

Regional Anesthesia and Pain Medicine

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“…We observed a significant increase in StO 2 after the onset of locoregional anesthesia. This was expected because brachial plexus block causes functional sympathectomy-like effects that lead to a complete vasodilatation and a subsequent increase in blood flow, microvascular arteriovenous shunting, and ultimately an increase in oxygen saturation [19,20].…”

mentioning

confidence: 99%

Effects of prolonged ischemia on human skeletal muscle microcirculation as assessed by near-infrared spectroscopy

Tujjar

Gaudio

Tofani

et al. 2016

J Clin Monit Comput

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Near-infrared spectroscopy (NIRS) has been used to detect in vivo microvascular alterations by means of a vascular occlusion test. We sought to analyse by NIRS the microcirculatory profile of patients undergoing prolonged tourniquet-induced bloodless condition for extremity surgery, and compare the results with time of ischemia and comorbidities. We conducted a prospective observational study on 42 patients undergoing upper limb surgery. Regional anaesthesia was achieved and ischemia was induced by a tourniquet cuffed at 250 mmHg. The probe of a NIRS monitor (InSpectra 325, Hutchiston, USA) was placed on the brachial muscle, and muscle oxygen saturation (StO 2 ) was recorded continuously before anaesthesia, during and after surgery. The following variables were recorded: baseline StO 2 , StO 2 desaturation slope during occlusion (dSlope, units/s), resaturation rate following ischemia (RR, units/s), hyperaemic peak (peak, units), and duration of the hyperaemic period following ischemia (hyperaemic time, s). Values of dSlope were similar among all patients. RR and hyperaemic time were significantly correlated with the duration of ischemia, but not with comorbidities [p = 0.007 CI (-35.64 to -13.1), and p \ 0.001 CI (0.049-0.159), respectively]. Grouping patients by duration of ischemia (30, 60, or 90 min), we found a significant decrease in RR after 60 and 90 min (p \ 0.001 and p = 0.03, respectively). Hyperaemic peak was lower in the 90 min group (83.9 ± 6.8 vs.91.2 ± 5.7 %, p = 0.02) whereas the hyperaemic time was significantly increased (595 ± 136 vs. 429 ± 107 min, p \ 0.001). Alterations of skeletal muscle microcirculation were correlated with the duration of ischemia, but not with comorbidities. We observed an initial impairment of the microcirculatory recovery at 90 min of ischemia.

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“…Others have demonstrated similar improvements in regional blood flow following peripheral nerve blockade using either Doppler flow or NIRS (14–16). Payen et al.…”

Section: Discussionmentioning

confidence: 97%

“…Additionally, given the limited magnitude of the change, it is unlikely that this technology can be used to document a successful block while under anesthesia. In comparison with the adult population, this may be due to the fact that pediatric patients have healthy vasculature as demonstrated by the fact that the baseline NIRS of the patients in the current of 82-83% is higher than those generally noted in the adult population (16). It is possible that the results may differ in the awake state during the postoperative period especially if there is stimulation of the sympathetic nervous system because of pain.…”

Section: The Link Between Tissue Oxygenation and Surgical Wound Infecmentioning

confidence: 90%

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Changes in tissue oxygenation following caudal epidural blockade in infants and children

Bettesworth

Bhalla

Barry

et al. 2012

Pediatric Anesthesia

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Summary Background: Adequate tissue oxygenation is required for effective white blood cell function and bactericidal activity. Decreased tissue oxygenation has been shown to be a risk factor for perioperative wound infections. Regional anesthetic techniques result in a functional sympathetic block and may increase tissue oxygenation. The purpose of the current study is to prospectively evaluate changes in tissue oxygenation using a non‐invasive near‐infrared spectroscopy (NIRS) device following caudal epidural block in infants and children. Methods: Following standard anesthetic induction and general anesthesia with an endotracheal tube or laryngeal mask airway, the NIRS sensors were placed on two sites. One sensor was placed at a site affected by the caudal block (lower extremity), and the other sensor was placed on the arm, a site unaffected by the caudal block (upper extremity). The NIRS value was recorded at baseline and then again at 15, 30, and 45 min after the block. The caudal block was performed, after anesthetic induction and NIRS sensor placement, using bupivacaine 0.25% with epinephrine 1 : 200 000 or ropivacaine 0.2% with epinephrine 1 : 200 000 at a dose of 1 ml·kg−1. The inspired oxygen concentration after induction was held constant at 30%, and anesthesia was maintained with sevoflurane at 1 MAC. No other pharmacologic agents were administered. Results: Following the caudal epidural block, there was a statistically significant increase in the tissue oxygenation from the affected site. The NIRS value increased from a baseline of 83 ± 4 to 87 ± 3 at 15 min (P = 0.0001 vs baseline), 88 ± 4 at 30 min (P < 0.0001 vs baseline), and 87 ± 4 at 45 min (P < 0.0001 vs baseline). No change was noted on the unaffected site (upper extremity). Conclusion: There was a statistically significant increase in tissue oxygenation as measured by NIRS following caudal anesthesia in infants and children. Although the magnitude of the change was less, this study confirms the results of previous studies in adults showing an increase in tissue oxygenation following regional blockade.

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Noninvasive tissue oxygen saturation determined by near‐infrared spectroscopy following peripheral nerve block

Cited by 25 publications

References 23 publications

Peripheral Nerve Block Facilitates Acute Inflammatory Responses Induced by Surgical Incision in Mice

Peripheral Nerve Block Facilitates Acute Inflammatory Responses Induced by Surgical Incision in Mice

Effects of prolonged ischemia on human skeletal muscle microcirculation as assessed by near-infrared spectroscopy

Changes in tissue oxygenation following caudal epidural blockade in infants and children

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