灌注指数值在腋路阻滞成功中的应用。

Perfusion Index Value in Determining the Success of Axillary Block.

机构信息

Department of Anaesthesiology and Reanimation, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey.

Adiyaman Provincial Health Department, Adiyaman, Turkey.

出版信息

J Coll Physicians Surg Pak. 2022 Sep;32(9):1105-1109. doi: 10.29271/jcpsp.2022.09.1105.

DOI:10.29271/jcpsp.2022.09.1105

PMID:36089703

Abstract

OBJECTIVE

To evaluate whether the perfusion index (PI) can be used to predict and provide a cut-off value for ultrasound-guided axillary nerve block success.

STUDY DESIGN

Quasi-experimental study.

PLACE AND DURATION OF STUDY

Department of Anaesthesiology and Reanimation, Adiyaman University Training and Research Hospital, Adiyaman, Turkey, from July to August 2020.

METHODOLOGY

Fifty patients between the ages of 18 and 65 years, who were in the ASA 1-2 group, undergoing hand, wrist and forearm surgery, were included in the study. PI value was measured from the extremity to the block and the healthy extremity before and after the procedure. Sensory block was evaluated with the pin-prick test, Motor block was evaluated with the Modified Bromage Scale. The minutes when sensory and motor blocks occurred were recorded, and the PI value at these moments were recorded.

RESULTS

Pin-prick test was positive in patients at average 8.4±2.4 minutes. The average PI value for which the pin-prick test was positive was 7.41±2.54, and the cut-off value of the sensory block PI ratio was determined as 1.7 times. The modified Bromage scale reached a score of 2 in 7.6±2.3 minutes on average. The average PI value is 7.27±2.69 for which the modified Bromage Scale score is 2. At modified Bromage Scale-2, PI ratio cut-off value was determined as 1.7 times. The modified Bromage Scale reached a score of 3 in an average of 12.6±4.2 minutes. The mean PI value for the modified Bromage Scale score of 3 is 9.56±6.97. The motor block PI ratio cut-off value was determined as 1.9 times.

CONCLUSION

Pulse oximetry perfusion index is a sensitive and simple method that can be used to evaluate the success of axillary block. The cut-off value, indicating successful block for the rate of sensory block and modified Bromage scale PI, was determined as 1.7 times and the motor block PI ratio as 1.9 times.

KEY WORDS

Axillary block, Perfusion index, Oximetry, Ultrasonography, Modified bromage scale.

摘要

目的

评估灌注指数（PI）是否可用于预测并提供超声引导腋神经阻滞成功的截断值。

研究设计

准实验研究。

地点和研究时间

土耳其阿迪亚曼大学培训与研究医院麻醉与复苏系，2020 年 7 月至 8 月。

方法

纳入年龄在 18 至 65 岁之间、ASA 1-2 级、行手部、腕部和前臂手术的 50 例患者。在操作前后，从肢体到阻滞部位和健康肢体测量 PI 值。感觉阻滞采用针刺试验评估，运动阻滞采用改良 Bromage 量表评估。记录感觉和运动阻滞发生的时间，并记录此时的 PI 值。

结果

针刺试验在患者平均 8.4±2.4 分钟时呈阳性。针刺试验阳性的平均 PI 值为 7.41±2.54，感觉阻滞 PI 比值的截断值确定为 1.7 倍。改良 Bromage 量表平均在 7.6±2.3 分钟达到 2 分。改良 Bromage 量表评分为 2 时的平均 PI 值为 7.27±2.69。改良 Bromage 量表评分为 2 时，PI 比值截断值确定为 1.7 倍。改良 Bromage 量表平均在 12.6±4.2 分钟达到 3 分。改良 Bromage 量表评分为 3 时的平均 PI 值为 9.56±6.97。运动阻滞 PI 比值截断值确定为 1.9 倍。