Peripheral Perfusion Index as a Predictor of Successful Supraclavicular Brachial Plexus Block

Peripheral Perfusion Index as a Predictor of Successful Supraclavicular Brachial Plexus Block in Patients Undergoing Hand Surgeries

Aim of the study is to determine the best cut off value for the PI and PI ratio for predication of successful supraclavicular brachial plexus block in young and middle age patients undergoing hand surgeries .

Study Overview

• Status: Not yet recruiting
• Conditions: Perfusion Index
• Intervention / Treatment: Other: Measurement of perfusion index after supraclavicular brachial plexus block at blocked & unblocked limb

Detailed Description

• The supraclavicular nerve block was performed under guidance of a linear transducer (8-14 MHz; Acuson x300; Siemens Healthcare, Seoul, Korea) over the supraclavicular fossa in the coronal oblique plane immediately superior to the midclavicular point. The block was induced in the semi-sitting position, with the head of the patient turned away from the side to be blocked.
• The PI was measured using Masimo SET pulse oximeter, applied on the index finger. The PI was recorded at baseline and at 10, 20, and 30min after local anaesthetic injection in both the blocked limb and the contralateral unblocked limb using two separate oximeters.
• The PI ratio was calculated as the ratio between the PI at 10min after injection and the baseline PI. In every patient, a comparison between the blocked and unblocked limb was performed.
• PI was recorded at baseline and at 10, 20, and 30 min after local anaesthetic injection in both the blocked limb and the contralateral unblocked limb.
• PI ratio was calculated as the ratio between the PI at 10 min after injection and the baseline PI.
• Vital data (Blood pressure, Heart rate, SPO2) was recorded before giving the block and at 10, 20, and 30 min after local anaesthetic injection and at the end of the operation.

• Study Type: Observational
• Enrollment (Estimated): 43

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

All patients undergoing elective hand surgeries at El-demerdash Hospital of Surgery during the study period.

Description

Inclusion Criteria:

• Adult patients aging between 15_ 60 years of both sexes.
• Patients undergoing Elective hand Surgeries under successful supraclavicular brachial plexus block anesthesia.
• American Society of Anesthesiologists (ASA) physical status classes I - II.

Exclusion Criteria:

• Patient's refusal of procedure or participation in the study.
• ASA classes III or above.
• Coagulopathy and bleeding disorders.
• Contraindications to supraclavicular brachial plexus block anesthesia such as local infection.
• Hypersensitivity to the study medications.
• Diabetes mellitus.
• Peripheral vascular disease.
• Emergency surgeries.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Perfusion index at the blocked & unblocked limb; The Perfusion Index was recorded at baseline and at 10, 20, and 30 min after local anaesthetic injection in both the blocked limb and the contralateral unblocked limb using two separate oximeters. In every patient , a comparison between the blocked and unblocked limb was performed .

Other: Measurement of perfusion index after supraclavicular brachial plexus block at blocked & unblocked limb; The PI (Perfusion Index) was measured using Masimo SET pulse oximetry applied on the index finger. The PI was recorded at baseline and at 10 , 20 , and 30 min after local anaesthetic injection in both the blocked limb and the contralateral unblocked limb using two separate oximeters. The PI ratio was calculated as the ratio between the PI at 10min after injection and the baseline PI. In every patient, a comparison between the blocked and unblocked limb was performed .

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cut off value for perfusion index ( PI ) for predication of successful supraclavicular brachial plexus block.	Perfusion index (PI) was recorded at baseline and at 10, 20, and 30 minutes after local anaesthetic injection in both the blocked limb and the contralateral unblocked limb.	Perfusion index (PI) was recorded at baseline and at 10, 20, and 30 minutes after local anaesthetic injection in both the blocked limb and the contralateral unblocked limb.
Cut off value for perfusion index (PI) ratio for predication of successful supraclavicular brachial plexus block.	Perfusion index (PI) ratio was calculated as the ratio between the PI at 10 minutes after injection and the baseline PI.	Perfusion index ( PI ) ratio was recorded at baseline and 10 minutes after local anaesthetic injection

Collaborators and Investigators

• Sponsor: Ain Shams University

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2024
• Primary Completion (Estimated): November 1, 2024
• Study Completion (Estimated): December 1, 2024

Study Registration Dates

• First Submitted: May 12, 2024
• First Submitted That Met QC Criteria: July 7, 2024
• First Posted (Actual): July 10, 2024

Study Record Updates

• Last Update Posted (Actual): August 6, 2024
• Last Update Submitted That Met QC Criteria: August 3, 2024
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Keywords: Brachial plexus block; Supraclavicular block; Perfusion index ( PI )
• Other Study ID Numbers: FMASU MS 726/2023

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No