Is Perfusion Index an Indicator of Block Success in Ultrasound-guided Infraclavicular Brachial Plexus Block

Study Overview
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Brief Summary
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The infraclavicular nerve block, which is frequently preferred in upper extremity surgeries, provides additional advantages such as reduction in opioid consumption by providing analgesic effect in the postoperative period as welll. The success of peripheral nerve blocks is usually assessed by subjective feedback from the patient, and patient cooperation is needed. The aim of this study is to assess whether the perfusion index level, which can be measured noninvasively, can be a predictor of the infraclavicular block success.

Detailed Description
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Thirty patients who were operated on for carpal tunnel syndrome under infraclavicular brachial plexus block were included in our study. After the procedure, at 10-minute intervals, the sensory block was assessed by a pinprick test, and the motor block was assessed by the ability to flex the hand and the forearm. In addition, PI and skin temperature were measured 0-10-20-30 minutes after the block and at postoperative 2, 4, and 6 hours. 30 minutes after the measurements, the surgical procedure was allowed to begin in patients with successful block.

Official Title
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Comparison of Block Success in Patients Undergoing Ultrasound-guided Infraclavicular Brachial Plexus Block With Bilateral Upper Extremity Perfusion Index

Conditions
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Carpal Tunnel Syndrome, Perfusion Index

Intervention / Treatment
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* Procedure: Infraclavicular nerve block
* Procedure: Without nerve block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ages of 18-75 Patients who will diagnose with carpal tunnel syndrome by electroneuromyography (ENMG), and will undergo unilateral surgery under elective conditions ASA I-II-III patients Exclusion Criteria: Patients who will refuse this method Neurological deficits, Diabetes mellitus, Local anesthetic allergy, Morbidly obese, Peripheral vascular disease, coronary artery disease, or coagulopathy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Blocked arm<br>The investigators performed an infraclavicular nerve block to the operated arm group to provide anesthesia. | Procedure: Infraclavicular nerve block<br>* The investigators performed an infraclavicular nerve block to the operated arm group to provide anesthesia.<br>|
| Active Comparator: Unblocked arm<br>The upper extremity without block was assigned as the control group, and a comparison was made between the two upper extremities. | Procedure: Without nerve block<br>* The upper extremity without block was assigned as the control group, and a comparison was made between the two upper extremities.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of whether perfusion index is a reliable and objective method to indicate block success | Perfusion index was measured up to 6 hours after the procedure. | 6 hours postprocedurly | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determining of a cut-off value for PI and PI ratio for a successful block. | There may be changes in the cut-off value depending on the applied plexus area, local anesthesia, volume and concentration of LA and the applied assistive technique (ultrasound or nerve stimulator). For both this reason and due to the high variability in the PI values, the PI ratio was calculated to predict block success. | Up to 6 hours after the procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Infraclavicular block, Perfusion index, Ultrasonography, Block assessment