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Abstract
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Background and Aims Ultrasound-guided supraclavicular brachial blocks are increasingly utilized for their efficacy and safety in upper limb surgeries. However, traditional methods for assessing block success lack precision. This study investigates the potential of the perfusion index (PI), a non-invasive measure of peripheral perfusion, to predict block success and establishes a cut-off value for its application.
Methods Seventy-seven ASA 1 and 2 patients aged 18-60 undergoing upper limb surgeries participated. Baseline PI values were recorded bilaterally pre-block. PI measurements were taken every five minutes for 30 minutes post-block, alongside sensory and motor block assessments. The PI ratio, comparing PI post-10 minutes to baseline, was computed. Predictive accuracy was evaluated using a receiver operating characteristic curve.
Results The operated limb consistently exhibited higher PIs throughout the study period. A PI ratio of 2.2 demonstrated 100% sensitivity and specificity in predicting block success.
Mean perfusion index at 0,5,10,15,20,25,30 minutes in blocked arm
ROC curve with PI ratio
Above table illustrates mean at 0,5,10,15,20,25,30 minutes in successfully blocked arm using ANOVA test. p valueis.000which is highly significant
Mean perfusion index at 0,5,10,15,20,25,30 minutes in blocked arm
ROC curve with PI ratio
Mean perfusion index at 0,5,10,15,20,25,30 minutes in blocked arm
ROC curve with PI ratio
Above table illustrates mean at 0,5,10,15,20,25,30 minutes in successfully blocked arm using ANOVA test. p valueis.000which is highly significant
Conclusions The study establishes the reliability of PI as a predictor for successful supraclavicular brachial blocks, offering a superior alternative to conventional methods. Incorporating PI measurement into these blocks holds promise for improving procedural outcomes. Further research is warranted to validate these findings and explore broader clinical applications