Perfusion Index for Predicting Brachial Plexus Block Success Under General Anesthesia

Korea University

Status: Completed

Conditions: Disorder of Shoulder

Treatments: Procedure: Interscalene brachial plexus blocks with ultrasound guidance under general anesthesia

Study type: Observational

Funder types: Other

Identifiers

NCT04925505

2021GR0104

Details and patient eligibility

About

This study was designed to determine whether the success or failure of interscalene brachial plexus block under general anesthesia can be predicted using perfusion index (PI).

Full description

The success of peripheral nerve blocks is usually evaluated by assessment of sensory and motor function; however, this method cannot be applied in the patient who has uncheckable mental status, e.g. general anesthesia, or who is uncommunicable, e.g. different language user.

The perfusion index (PI) is a numerical value for the ratio between pulsatile and non-pulsatile blood flow measured by a special pulse oximeter, and PI had been proved as a useful tool for evaluation of successful supraclavicular nerve block in awake patients as an objective method.

With the use of ultrasound guidance in skilled hands, it is a reasonable option to perform neuraxial and peripheral regional blocks in sedated or anesthetized patients. However, there has been no evidence of applying PI for predicting the success of nerve block in general anesthetized patients.

Enrollment: 70 patients

Sex: All

Ages: 20 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 20-70 years old,
• BMI 20-35 kg.m-2,
• elective shoulder surgery,
• ASA physical status I-III

Exclusion criteria

• refusal of the patient,
• comorbid with serious vascular disease,
• diabetes,
• allergy to local anesthetics,
• patients on regular opioids,
• peripheral neuropathy.

Trial design

70 participants in 2 patient groups

BPB success

Description:

The study included patients aged between 20 and 70 yr who are to undergo elective shoulder surgery under general anesthesia. Patients undergo general anesthesia induction before the interscalene block is performed. Ultrasound-guided interscalene brachial plexus block will be performed in anesthetized patients before surgery. PI monitor will be applied to both blocked and non-blocked limbs using two separate oximeters. And the SUCCESS (or failure) of the block will be confirmed by (1) 30% change of heart rate and blood pressure after incision during operation, and (2) pain score, motor and sensory function test after surgery in the post-anesthesia recovery unit.

Treatment:

Procedure: Interscalene brachial plexus blocks with ultrasound guidance under general anesthesia

BPB failure

Description:

The study included patients aged between 20 and 70 yr who are to undergo elective shoulder surgery under general anesthesia. Patients undergo general anesthesia induction before the interscalene block is performed. Ultrasound-guided interscalene brachial plexus block will be performed in anesthetized patients before surgery. PI monitor will be applied to both blocked and non-blocked limbs using two separate oximeters. And the (success or) FAILURE of the block will be confirmed by (1) 30% change of heart rate and blood pressure after incision during operation, and (2) pain score, motor and sensory function test after surgery in the post-anesthesia recovery unit.

Treatment:

Procedure: Interscalene brachial plexus blocks with ultrasound guidance under general anesthesia