The perfusion index could early predict a nerve block success: A preliminary report

Abstract This study aimed to evaluate the diagnostic value of ultrasonographic parameters as an indicator for predicting regional nerve block success. Ultrasound-guided sciatic nerve block was performed in seven dogs using either 2% mepivacaine (nerve-block group) or saline (sham-block group). The cross-sectional area (CSA), nerve blood flow (NBF), and shear wave velocity (SWV) of the sciatic nerve (SWVN), SWV of the biceps femoris muscle (SWVM), and their ratio (SWVNMR) were measured at 0, 30, 60, and 90 min after the nerve block as well as the change rate of each parameter from the baseline. A receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic value of each parameter in the prediction of nerve block success. No significant changes were observed in the CSA or NBF in association with the nerve block. The SWVN and SWVNMR in the nerve-block group were significantly higher than those in the sham-block group at 90 min and at 30, 60, and 90 min, respectively (p < 0.05). The change rates of SWVN and SWVNMR in the nerve-block group were significantly higher than those in the sham-block group at all time points (p < 0.05). The ROC curve analysis showed that SWVN had a moderate diagnostic accuracy (area under the curve [AUC], 0.779), whereas SWVNMR and change rates of SWVN and SWVNMR had a high diagnostic accuracy (AUC, 0.947, 0.998, and 1.000, respectively). Ultrasonographic evaluation of the SWVN and SWVNMR could be used as indicators for predicting nerve block success.

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Comparative of the Effectiveness of Different Objective Method for Infraclavicular Brachial Plexus Block Success; Which One of Them is A Reliable and Early Indicator?

10.1101/2021.06.26.21259567 ◽

2021 ◽

Author(s):

Abdulhakim Sengel ◽

Mahmut alp Karahan ◽

Nuray Altay ◽

Orhan Binici ◽

Veli fahri Pehlivan ◽

...

Keyword(s):

Body Temperature ◽

Peripheral Nerve ◽

Nerve Block ◽

Peripheral Nerve Block ◽

Temperature Measurements ◽

Tissue Oxygen Saturation ◽

Block Success ◽

Significant Difference ◽

Plexus Block ◽

Tissue Hemoglobin

ABSTRACT BACKGROUND Traditional methods that evaluate the success of peripheral nerve block have been replaced by methods that allow objective evaluations over time. Multiple objective techniques for peripheral nerve block have been discussed in the literature. OBJECTIVE This study aims to investigate whether perfusion index (PI), non-invasive tissue hemoglobin monitoring (SpHb), tissue oxygen saturation (StO2), tissue hemoglobin index (THI) and body temperature are reliable and objective methods to evaluate the adequacy of infraclavicular blockage. DESIGN A prospective observational study. SETTING Single center, Department of Anesthesiology, Harran University Medical Faculty, Turkey, from February 2019 to December 2019. PATIENTS A total of 100 patients scheduled to undergo forearm surgery. INTERVENTION Ultrasound-guided infraclavicular block (ICB) in 100 patients undergoing forearm surgery. MAIN OUTCOME MEASURES PI, SpHb, StO2, THI and Body Temperature measurements were recorded 5 min before the block procedure, right after the procedure, and until the 25th minute after the procedure at 5-min intervals. These values were compared between the blocked limbs and non-blocked limbs while being statistically compared between the successful and failed block groups. RESULTS Although there were significant differences between the groups of blocked extremity and non-blocked extremity in terms of StO2 (P = 0.001), THI (P = 0.001), PI (P = 0.001) and body temperature (P = 0.001), there was no significant difference between these groups in terms of SpHb (P > 0.05). Moreover, a significant difference was detected between the groups of successful block and failed block in terms of StO2 (P = 0.002), PI (P = 0.002) and body temperature (P = 0.005), while there was no significant difference between these groups in terms of THI (P > 0.05) and SpHb (P > 0.05). CONCLUSION StO2, PI and body temperature measurements are the simple, objective, noninvasive techniques to be used to evaluate success of block procedures. According to The receiver operating characteristic (ROC) analysis, StO2 is the specific parameter with the highest sensitivity among these parameters.

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Ultrasound-Guided Genicular Nerve Pulsed Radiofrequency Treatment For Painful Knee Osteoarthritis: A Preliminary Report

January 2018 - Pain Physician ◽

10.36076/ppj/2019.19.e751 ◽

2016 ◽

Vol 5;19 (5;19) ◽

pp. E751-E759 ◽

Cited By ~ 8

Author(s):

Dr. Serdar Kesikburun

Keyword(s):

Knee Osteoarthritis ◽

Knee Pain ◽

Nerve Block ◽

Study Design ◽

Preliminary Report ◽

Controlled Study ◽

Pulsed Radiofrequency ◽

Ultrasound Guided ◽

Chronic Knee Pain ◽

Pulsed Rf

Background: Genicular nerve ablation with radiofrequency (RF) has recently emerged as a promising treatment in the management of osteoarthritis related knee pain. To date, genicular nerve injections have been performed under fluoroscopic guidance. Objective: To evaluate the effect of ultrasound-guided genicular nerve pulsed RF treatment on chronic knee pain and function in patients with knee osteoarthritis. Study Design: Single-arm prospective study. Setting: University hospital and rehabilitation center in Turkey. Methods: A review was made of 29 patients with medial knee osteoarthritis who had undergone genicular nerve block in the previous 6 months. Patients with at least 50% reduction in the visual analog scale (VAS) score after genicular nerve block and with no on-going pain relief were selected for the study. Ultrasound-guided genicular nerve pulsed RF was applied to 15 knees of 9 patients. Pain and knee function were assessed with 100-mm VAS and Western Ontario and McMaster Universities (WOMAC) index throughout 3 months. Results: A significant reduction in VAS scores was detected over time after the pulsed RF procedure (f: 69.24, P < 0.01). There was a significant improvement in the WOMAC scores (f: 539.68 , P < 0.01). Limitations: The small number of participants, the lack of a control group, and short followup period were limitations of the study. Conclusions: Genicular nerve pulsed RF treatment has been found to be safe and beneficial in osteoarthritis related knee pain. Further studies with a larger population and randomized controlled study design are warranted to confirm the positive findings of this preliminary report. Key words: Knee pain, osteoarthritis, genicular nerve, ultrasonography, pulsed radiofrequency

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