Using the Perfusion Index for Block Success in Pediatric Patients: A Retrospective Study

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Oct 17

PMID 37846249

Authors

Gozde Altun

Engin Ihsan Turan

Ayca Sultan Sahin

Affiliations

Soon will be listed here.

Abstract

Study Objective: To investigate the efficacy of the perfusion index in assessing block success in pediatric patients undergoing elective supracondylar fracture repair surgery.

Methods: It was a retrospective study in a tertiary-care center. Twenty-eight pediatric supracondylar humerus fracture patients who underwent elective surgery for fracture repair were evaluated. Perfusion index, pulse rate, pleth variability index (PVi), and oxygen saturation were measured at different time intervals before and after the coracoid infraclavicular block procedure.

Main Results: The changes in perfusion index (PI) values were found to be statistically significant (p˂0.05). The Bonferroni analysis revealed that the results obtained at three separate measurement times differed significantly (p˂0.05). On the other hand, changes in other variables were not statistically significant (p˃0.05).

Conclusions: The perfusion index can be used as an indicator of block success in elective surgeries of the upper extremities in pediatric patients.

References

Abdelnasser A, Abdelhamid B, Elsonbaty A, Hasanin A, Rady A . Predicting successful supraclavicular brachial plexus block using pulse oximeter perfusion index. Br J Anaesth. 2017; 119(2):276-280. DOI: 10.1093/bja/aex166. View

Cetgen N, Ener D, Dogukan M, Duran M, Uludag O . Perfusion Index Value in Determining the Success of Axillary Block. J Coll Physicians Surg Pak. 2022; 32(9):1105-1109. DOI: 10.29271/jcpsp.2022.09.1105. View

Wang J, Deng L, Xu A . Evaluation of prediction effect of perfusion index for supraclavicular brachial plexus block in children: protocol for a randomized trial. Trials. 2022; 23(1):629. PMC: 9351202. DOI: 10.1186/s13063-022-06597-y. View

Abdelhamid B, Emam M, Mostafa M, Hasanin A, Awada W, Rady A . The ability of perfusion index to detect segmental ulnar nerve sparing after supraclavicular nerve block. J Clin Monit Comput. 2019; 34(6):1185-1191. DOI: 10.1007/s10877-019-00443-4. View

Hasanin A, Karam N, Mukhtar A, Habib S . The ability of pulse oximetry-derived peripheral perfusion index to detect fluid responsiveness in patients with septic shock. J Anesth. 2021; 35(2):254-261. DOI: 10.1007/s00540-021-02908-w. View

Ozturk N, Kavakli A . Comparison of the coracoid and retroclavicular approaches for ultrasound-guided infraclavicular brachial plexus block. J Anesth. 2017; 31(4):572-578. DOI: 10.1007/s00540-017-2359-6. View

Ootaki C, Hayashi H, Amano M . Ultrasound-guided infraclavicular brachial plexus block: an alternative technique to anatomical landmark-guided approaches. Reg Anesth Pain Med. 2000; 25(6):600-4. DOI: 10.1053/rapm.2000.18184. View

Kus A, Gurkan Y, Gormus S, Solak M, Toker K . Usefulness of perfusion index to detect the effect of brachial plexus block. J Clin Monit Comput. 2013; 27(3):325-8. DOI: 10.1007/s10877-013-9439-4. View

Kretz F, Krier C . [A child with a full stomach has to be anaesthesized]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2002; 37(9):514-9. DOI: 10.1055/s-2002-33763. View

10.

Rajan K, Dave N, Dias R, Muneshwar P, Kesarkar N, Saxena V . Perfusion index as a predictor of working pediatric caudal block under general anesthesia- A prospective observational study. J Anaesthesiol Clin Pharmacol. 2023; 38(4):635-639. PMC: 9912897. DOI: 10.4103/joacp.JOACP_34_21. View

11.

Nieuwveld D, Mojica V, Herrera A, Pomes J, Prats A, Sala-Blanch X . Medial approach of ultrasound-guided costoclavicular plexus block and its effects on regional perfussion. Rev Esp Anestesiol Reanim. 2016; 64(4):198-205. DOI: 10.1016/j.redar.2016.09.010. View

12.

Ginosar Y, Weiniger C, Meroz Y, Kurz V, Bdolah-Abram T, Babchenko A . Pulse oximeter perfusion index as an early indicator of sympathectomy after epidural anesthesia. Acta Anaesthesiol Scand. 2009; 53(8):1018-26. DOI: 10.1111/j.1399-6576.2009.01968.x. View

13.

Lima A, Beelen P, Bakker J . Use of a peripheral perfusion index derived from the pulse oximetry signal as a noninvasive indicator of perfusion. Crit Care Med. 2002; 30(6):1210-3. DOI: 10.1097/00003246-200206000-00006. View

14.

Elshal M, Hasanin A, Mostafa M, Gamal R . Plethysmographic Peripheral Perfusion Index: Could It Be a New Vital Sign?. Front Med (Lausanne). 2021; 8:651909. PMC: 8517109. DOI: 10.3389/fmed.2021.651909. View

15.

Seyhanli I, Duran M, Yilmaz N, Nakir H, Dogukan M, Uludag O . Investigation of infraclavicular block success using the perfusion index: A randomized clinical trial. Biomol Biomed. 2022; 23(3):496-501. PMC: 10171442. DOI: 10.17305/bjbms.2022.8214. View

16.

Maria B, Banus E, Navarro Egea M, Serrano S, Perello M, Mabrok M . Ultrasound-guided supraclavicular vs infraclavicular brachial plexus blocks in children. Paediatr Anaesth. 2008; 18(9):838-44. DOI: 10.1111/j.1460-9592.2008.02644.x. View

17.

Bereket M, Aydin B, Kucukosman G, Piskin O, Okyay R, Ayoglu F . Perfusion Index and ultrasonography in the evaluation of infraclavicular block. Minerva Anestesiol. 2019; 85(7):746-755. DOI: 10.23736/S0375-9393.18.13046-X. View