Validation of peripheral perfusion index in predicting successful supraclavicular brachial plexus block for upper extremity procedures in children

Document Type : Original Article

Authors

Department of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.

Abstract

Background: To validate the ability of peripheral perfusion index (PPI) to predict the success of supraclavicular brachial plexus block (SCBPB) in children undergoing upper extremity procedures.
Methods: This prospective observational study enrolled 55 pediatric patients aged 3-12 years, ASA class I-II scheduled for elective upper extremity procedures. Patients received general anesthesia and a trained anesthesiologist performed ultrasound guided SCBPB on the ipsilateral side of the procedure.
Results: PPI measurements from the blocked limb at 30 minutes were significantly higher than non-blocked limb compared to baseline readings. PPI, delta PPI and PI ratio were higher in blocked limb at 30 minutes than non-blocked limb (P<0.001). Skin temperature values from blocked limb were considerably higher at 30-min compared to baseline; however, measurements from non-blocked limb were insignificantly different at 30-min compared to baseline. Skin temperature and delta skin temperature were significantly higher in blocked limb than non-blocked at 30-min (P=0.031). PPI can significantly predict block success (P<0.001 and AUC=0.986) at cut-off≤0.5 with 100% sensitivity, 98.11% specificity, 50.0% PPV and 98.1% NPV. Temperature can’t predict block success (P=0.268 and AUC=0.642) at cut-off≤0.8 with 100% sensitivity, 45.28% specificity, 6.5% PPV and 100% NPV. PPI was stronger than temperature in prediction of block success (P=0.004).
Conclusion: Perfusion index is a valid measure for predicting the success of SCBPB in children undergoing upper limb surgery after induction of general anesthesia. Skin temperature is a valid measure of block success in adults; however, it is not as reliable as PI in children under general anesthesia.

Keywords

Main Subjects

Files

Share

How to cite

Statistics