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Evaluation of Brachial Plexus Block With Plethysmographic Variability Index and Perfusion Index

Year 2021, Volume: 18 Issue: 2, 170 - 175, 27.08.2021
https://doi.org/10.35440/hutfd.896408

Abstract


Background: Conventional methods for evaluation of block success are time consuming and need patient cooperation. The aim of this study was to evaluate whether the Perfusion Index and Plethysmographic Variability Index can be used to predict brachial nevre block success.
Materials and Methods: Thirty-four patients, aged 18-65 years, who were transferred to elective or emergency surgery were included. Brachial plexus block was applied. Those with cardiac disease, chronic obstructive pulmonary disease and asthma were excluded from the study. Bedside, non-invasive, serial plethysmographic variability index (PVI) and perfusion index (PI) measurements of the patients were made using the Radical-97 Pulse Oximeter device from the fourth finger tip of the blocked hand.
Results: When the PVI values measured from the blocked arm were compared; The difference between 0 and 5 minutes, 5th and 10th minutes and 0 to 10 minutes was statistically significant. When PI values were compared as 0 and 5 minutes, 5 and 10 minutes, 0 and 10 minutes, the changes were statistically significant. ( p<0.05).
Conclusion: In our study, it was seen that the changes in PI and PVI values were statistically significant. ( p<0.05) There was no statistically significant correlation between PVI and PI.

Key Words: Anaesthesia, Brachial Plexus Block, Hemodynamic Monitoring

References

  • 1- Graybeal JM, Petterson M, Novak J. Correlation of peripheral perfusion index with site to site delays in detection of desaturations. Anesthesiology 2002;96:595.
  • 2- Tsuchiya M, Yamada T, Asada A. Pleth variability index predicts hypotension during anesthesia induction. Acta Anaesthesiol Scand 2010;54:596-602.
  • 3. Keller G, Cassar E, Desebbe O, Lehot JJ, Canesson M. Ability of pleth variability index to detect hemodynamic changes induced by passive leg raising in spontaneously breathing volunteers. Critical Care [online] 2008;12:R37. URL: https://www.ccforum.biomedcentral.com/articles/10.1186/cc6822
  • 4. Yin JY, Ho KM. Use of plethysmographic variability index derived from the Masimow pulse oximeter to predict fluid or preload responsiveness: a systematic review and meta-analysis. Anaesthesia 2012;67:777–83.
  • 5. Bergek C, Zdolsek JH, Hahn RG. Non-invasive blood haemoglobin and plethysmographic variability index during brachial plexus block. Br J Anaesth 2015;114:812-17.
  • 6- Cannesson M, Desebbe O, Rosamel P, ve ark. Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatre. Br J Anaesth 2008;101:200–6.
  • 7- D’Alessio JG, Rosenblum M, Shea KP, Freitas DG. A retrospective comparison of interscalene block and general anesthesia for ambulatory surgery shoulder arthroscopy. Regional Anesthesia and Pain Medicine 1995;20:62-68.
  • 8. Mirza F, Brown AR. Ultrasound-Guided Regional Anesthesia for Procedures of the Upper Extremity. Anesthesiology Research and Practice [online] 2011;2011:579824. URL: http://www.europepmc.org/article/PMC/3119462
  • 9. Tsui B, Wagner A, Finucane B. Regional Anaesthesia in the Elderly, A Clinical Guide. Drugs Aging 2004;21:895-910.
  • 10. Abdelnasser A, Abdelhamid B, Elsonbaty A, Hasanin A, Rady A. Predicting successful supraclavicular brachial plexus block using pulse oximeter perfusion index. Br J Anaesth 2017;119:276–80.
  • 11. Ginosar Y, Weiniger CF, Meroz Y, ve ark. Pulse oximeter perfusion index as an early indicator of sympathectomy after epidural anesthesia. Acta Anaesthesiol Scand 2009;53:10118-26.
  • 12. Galvin EM, Niehof S, Verbrugge SJ, ve ark. Peripheral flow index is a reliable and early indicator of regional block success. Anesth Analg 2006;103:239-43.
  • 13. Klodell CT, Lobato EB, Willert JL, Gravenstein N. Oximetry-Derived Perfusion Index for Intraoperative Identification of Successful Thoracic Sympathectomy. Ann Thorac Surg 2005; 80:467–70.
  • 14.Sebastiani A, Philippi L, Boehme S, ve ark. Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters. Can J Anesth 2012;59:1095-1101.
  • 15. Takeyama M, Matsunaga A, Kakihana Y, Masuda M, Kuniyoshi T, Kanamara Y. Impact of skin incision on the pleth variability index. J Clin Monit Comput 2011;25:215-21.
  • 16. Iskandar H, Wakim N, Benard A, ve ark. The effects of interscalene brachial plexus block on humeral arterial blood flow: a Doppler ultrasound study. Anesth Analg 2005;101:279-81.
  • 17. Karahan MA, Atlas A, Pehlivan VF, ve ark. Spontan Solunumu Olan Gönüllülerde Cerrahi Hasta Pozisyonlarının Plet Değişkenlik İndeksi , Perfüzyon İndeksi ve Noninvaziv Sürekli Kardiyak Output Ölçüm Yöntemi Üzerine Olan Etkisi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2020;17:98-103.
  • 18. Kart CE, İsbir AC, Avcı O, Kol Öİ, Kaygusuz K, Gürsoy S. The Effects of Interscalene Block Performed Alone or with Ultrasonography-Guided Peripheric Nerve Stimulator on Block Success, Hemodynamic Parameters and Perfusion Index. Turkiye Klinikleri J Cardiovasc Sci 2020;32:37-44.
  • 19. Kus A, Gürkan Y, Görmüş SK, Solak M, Toker K. Usefulness of perfusion index to detect the effect of brachial plexus block. J Clin Monit Comput 2013;325–28.
  • 20. Pavithra SM, Swetha J, Shruthi RS. Clinical Usage of Peripheral Perfusion Index in Individuals with Pain – A Preliminary Study. IJRASET 2018;6:1535-40.
  • 21. Bereket MM, Aydın BG, Küçükosman G, ve ark. Perfusion Index and ultrasonography in the evaluation of infraclavicular block. Minerva Anestesiol 2019;85:746-55.
  • 22. Chu CL, Huang YY, Chen YH, Lai LP, Yeh HM. An observational study: The utility of perfusion index as a discharge criterion for pain assessment in the postanesthesia care unit. PLoS ONE 2018;13:e0197630.
  • 23. Waghalkar P and Akude N. Comparison of perfusion index (PI) with other non-invasive hemodynamic monitors of stress response following endotracheal intubation. International Journal of Biomedical Research 2016;7:490-494.
  • 24. Mohamed SAR, Mohamed NN, Rashwan D. Pulse co-oximetry perfusion index as a tool for acute postoperative pain assessment and its correlation to visual analogue pain score. Research and Opinion in Anesthesia& Intensive Care 2015;2:62–67.
  • 25. Hagar H, Church S, Mandadi G, Pulley D, Kurz A. The perfusion index as measured by a pulse oximeter indicates pain stimuli in anesthetized volunteers. Anesthesiology 2004;101:A514.
  • 26. Hasanin A, Mohamed SAR, El-adawy A. Evaluation of perfusion index as a tool for pain assessment in critically ill patients. J Clin Monit Comput 2017;31:961–965.
  • 27. Kupeli I, Kulhan NG. Can Perfusion Index be used as an Objective Tool for Pain Assessment in Labor Analgesia Pak J Med Sci. 2018;34:1262-1266.

Brakial Pleksus Bloğunun Pletismografik Variabilite İndeksi ve Perfüzyon İndeksi ile Değerlendirilmesi

Year 2021, Volume: 18 Issue: 2, 170 - 175, 27.08.2021
https://doi.org/10.35440/hutfd.896408

Abstract

Amaç: Blok başarısının değerlendirilmesi kullanılan için geleneksel yöntemler zaman alıcıdır ve hasta kooperasyonuna ihtiyaç duyar. Bu çalışmanın amacı Perfüzyon İndeksi ve Pletismografik Variabilite İndeksinin brakiyal sinir blokajının başarısını tahmin etmek için kullanılıp kullanılamayacağını değerlendirmektir.

Materyal ve metod: Bu çalışmaya 18-65 yaş arası, elektif veya acil cerrahi operasyona alınan 34 hasta dahil edildi. Brakial pleksus bloğu uygulandı. Kardiyak hastalığı, kronik obstrüktif akciğer hastalığı ve astım hastalığı olanlar çalışma dışı bırakıldı. Hastaların yatak başı, noninvaziv, seri pletismografik variabilite indeksi (PVI) ve perfüzyon indeksi (PI) ölçümleri, blok uygulanan elin dördüncü parmak ucundan Radical-97 Pulse Oksimetre cihazı kullanılarak yapıldı.

Bulgular: Blok yapılan koldan ölçülen PVI değerleri karşılaştırıldığında; 0 ile 5. dk, 5. dk ile 10. dk ve 0 ile 10.dk arasındaki farklılık istatistiksel olarak anlamlı bulundu. PI değerleri 0 ve 5.dk, 5 ve 10.dk, 0 ve 10.dk olarak karşılaştırıldığında değişimler istatistiksel olarak anlamlı bulundu. ( p<0.05)

Sonuç: Çalışmamızda PI ve PVI değerindeki değişimlerin istatistiksel olarak anlamlı olduğu görüldü. ( p<0.05) PVI ve PI arasında istatistiksel olarak anlamlı korelasyon saptanmadı.

References

  • 1- Graybeal JM, Petterson M, Novak J. Correlation of peripheral perfusion index with site to site delays in detection of desaturations. Anesthesiology 2002;96:595.
  • 2- Tsuchiya M, Yamada T, Asada A. Pleth variability index predicts hypotension during anesthesia induction. Acta Anaesthesiol Scand 2010;54:596-602.
  • 3. Keller G, Cassar E, Desebbe O, Lehot JJ, Canesson M. Ability of pleth variability index to detect hemodynamic changes induced by passive leg raising in spontaneously breathing volunteers. Critical Care [online] 2008;12:R37. URL: https://www.ccforum.biomedcentral.com/articles/10.1186/cc6822
  • 4. Yin JY, Ho KM. Use of plethysmographic variability index derived from the Masimow pulse oximeter to predict fluid or preload responsiveness: a systematic review and meta-analysis. Anaesthesia 2012;67:777–83.
  • 5. Bergek C, Zdolsek JH, Hahn RG. Non-invasive blood haemoglobin and plethysmographic variability index during brachial plexus block. Br J Anaesth 2015;114:812-17.
  • 6- Cannesson M, Desebbe O, Rosamel P, ve ark. Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatre. Br J Anaesth 2008;101:200–6.
  • 7- D’Alessio JG, Rosenblum M, Shea KP, Freitas DG. A retrospective comparison of interscalene block and general anesthesia for ambulatory surgery shoulder arthroscopy. Regional Anesthesia and Pain Medicine 1995;20:62-68.
  • 8. Mirza F, Brown AR. Ultrasound-Guided Regional Anesthesia for Procedures of the Upper Extremity. Anesthesiology Research and Practice [online] 2011;2011:579824. URL: http://www.europepmc.org/article/PMC/3119462
  • 9. Tsui B, Wagner A, Finucane B. Regional Anaesthesia in the Elderly, A Clinical Guide. Drugs Aging 2004;21:895-910.
  • 10. Abdelnasser A, Abdelhamid B, Elsonbaty A, Hasanin A, Rady A. Predicting successful supraclavicular brachial plexus block using pulse oximeter perfusion index. Br J Anaesth 2017;119:276–80.
  • 11. Ginosar Y, Weiniger CF, Meroz Y, ve ark. Pulse oximeter perfusion index as an early indicator of sympathectomy after epidural anesthesia. Acta Anaesthesiol Scand 2009;53:10118-26.
  • 12. Galvin EM, Niehof S, Verbrugge SJ, ve ark. Peripheral flow index is a reliable and early indicator of regional block success. Anesth Analg 2006;103:239-43.
  • 13. Klodell CT, Lobato EB, Willert JL, Gravenstein N. Oximetry-Derived Perfusion Index for Intraoperative Identification of Successful Thoracic Sympathectomy. Ann Thorac Surg 2005; 80:467–70.
  • 14.Sebastiani A, Philippi L, Boehme S, ve ark. Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters. Can J Anesth 2012;59:1095-1101.
  • 15. Takeyama M, Matsunaga A, Kakihana Y, Masuda M, Kuniyoshi T, Kanamara Y. Impact of skin incision on the pleth variability index. J Clin Monit Comput 2011;25:215-21.
  • 16. Iskandar H, Wakim N, Benard A, ve ark. The effects of interscalene brachial plexus block on humeral arterial blood flow: a Doppler ultrasound study. Anesth Analg 2005;101:279-81.
  • 17. Karahan MA, Atlas A, Pehlivan VF, ve ark. Spontan Solunumu Olan Gönüllülerde Cerrahi Hasta Pozisyonlarının Plet Değişkenlik İndeksi , Perfüzyon İndeksi ve Noninvaziv Sürekli Kardiyak Output Ölçüm Yöntemi Üzerine Olan Etkisi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2020;17:98-103.
  • 18. Kart CE, İsbir AC, Avcı O, Kol Öİ, Kaygusuz K, Gürsoy S. The Effects of Interscalene Block Performed Alone or with Ultrasonography-Guided Peripheric Nerve Stimulator on Block Success, Hemodynamic Parameters and Perfusion Index. Turkiye Klinikleri J Cardiovasc Sci 2020;32:37-44.
  • 19. Kus A, Gürkan Y, Görmüş SK, Solak M, Toker K. Usefulness of perfusion index to detect the effect of brachial plexus block. J Clin Monit Comput 2013;325–28.
  • 20. Pavithra SM, Swetha J, Shruthi RS. Clinical Usage of Peripheral Perfusion Index in Individuals with Pain – A Preliminary Study. IJRASET 2018;6:1535-40.
  • 21. Bereket MM, Aydın BG, Küçükosman G, ve ark. Perfusion Index and ultrasonography in the evaluation of infraclavicular block. Minerva Anestesiol 2019;85:746-55.
  • 22. Chu CL, Huang YY, Chen YH, Lai LP, Yeh HM. An observational study: The utility of perfusion index as a discharge criterion for pain assessment in the postanesthesia care unit. PLoS ONE 2018;13:e0197630.
  • 23. Waghalkar P and Akude N. Comparison of perfusion index (PI) with other non-invasive hemodynamic monitors of stress response following endotracheal intubation. International Journal of Biomedical Research 2016;7:490-494.
  • 24. Mohamed SAR, Mohamed NN, Rashwan D. Pulse co-oximetry perfusion index as a tool for acute postoperative pain assessment and its correlation to visual analogue pain score. Research and Opinion in Anesthesia& Intensive Care 2015;2:62–67.
  • 25. Hagar H, Church S, Mandadi G, Pulley D, Kurz A. The perfusion index as measured by a pulse oximeter indicates pain stimuli in anesthetized volunteers. Anesthesiology 2004;101:A514.
  • 26. Hasanin A, Mohamed SAR, El-adawy A. Evaluation of perfusion index as a tool for pain assessment in critically ill patients. J Clin Monit Comput 2017;31:961–965.
  • 27. Kupeli I, Kulhan NG. Can Perfusion Index be used as an Objective Tool for Pain Assessment in Labor Analgesia Pak J Med Sci. 2018;34:1262-1266.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Enes Çelik 0000-0002-5546-4924

Gönül Ölmez Kavak 0000-0002-7745-7506

Publication Date August 27, 2021
Submission Date March 17, 2021
Acceptance Date July 8, 2021
Published in Issue Year 2021 Volume: 18 Issue: 2

Cite

Vancouver Çelik E, Ölmez Kavak G. Brakial Pleksus Bloğunun Pletismografik Variabilite İndeksi ve Perfüzyon İndeksi ile Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2021;18(2):170-5.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty