Skin temperature measured by infrared thermography after ultrasound‐guided blockade of the sciatic nerve

Haren, F.G.A.M. van; Kadic, L.; Driessen, J. J.

doi:10.1111/aas.12170

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…It has been speculated that direct chemical or pharmacological stimulation of afferent thermal fibres by the local anaesthetic might cause this phenomenon . The increase of skin temperature has been reconfirmed by several authors . It is also detectable in geriatric patients and infants .…”

Section: Skin Temperature As An Indicator Of Regional Anaesthesia Sucmentioning

confidence: 71%

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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: Skin Temperature As An Indicator Of Regional Anaesthesia Sucmentioning

confidence: 71%

“…More proximally, no temperature changes were detected. Since skin temperature increased before pinprick sensation was reduced the authors concluded that skin temperature measurement represents a good test for determining block success when sensory testing is impossible …”

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

“…14 In addition, the sympathetic portion of the three investigated nerves is not described (different to, e.g. the sciatic nerve, where a large portion of sympathetic fibres can be assumed 15 ) and may differ between the three nerves.…”

Section: Sensory Testingmentioning

confidence: 99%

Cutaneous innervation of the hand: clinical testing in volunteers shows high intra- and inter-individual variability

Keplinger

Marhofer

Moriggl

et al. 2018

British Journal of Anaesthesia

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“… and van Haren et al. . Similarly, higher sensitivity and specificity were found for perfusion indices .…”

Section: Testing Of Onset and Assessing Readiness For Surgerymentioning

confidence: 75%

“…Methods based on change in skin temperature resulting from sympathetic blockade have been explored as an indicator for block success. Skin temperature has been measured by infrared thermography , with a thermometer or by simply feeling the patient's skin . In addition, a brief case report described how a patient's temperature‐sensitive nail varnish changed colour after onset of a peripheral nerve block of the arm in question!…”

Section: Testing Of Onset and Assessing Readiness For Surgerymentioning

confidence: 99%

Monitoring regional blockade

2017

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This review attempts to draw on the published literature to address three practical clinical questions. First, what means of testing the degree of regional blockade pre-operatively are available, and can eventual success or failure be determined soon after injection? Second, is it possible to predict if a block inserted after the induction of general anaesthesia will be effective when the patient wakes? Third, what features, and what duration, should cause concern when a block does not resolve as expected after surgery? Although the relevant literature is limited, we recommend testing of multiple sensory modalities before surgery commences; temperature and thermographic changes may offer additional early warning of success or failure. There are a number of existing methods of assessing nociception under general anaesthesia, but none has yet been applied to gauge the onset of a regional block. Finally, criteria for further investigation and neurological referral when block symptoms persist postoperatively are presented.

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Skin temperature measured by infrared thermography after ultrasound‐guided blockade of the sciatic nerve

Cited by 9 publications

References 11 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

Cutaneous innervation of the hand: clinical testing in volunteers shows high intra- and inter-individual variability

Monitoring regional blockade

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