European Journal of Molecular & Clinical Medicine

Abstract

Background: Brachial plexus blocking is a tested technique for performing upper limb procedures. The traditional approach employing the paresthesia technique is a blind technique that may be associated with a greater failure rate and nerve and surrounding structural harm. Perfusion index (PI) is a new simple, objective, and non-invasive method for the evaluation of the success of central neuraxial and peripheral nerve blocks.
Methods: A total of n=60 cases were included in the study following the inclusion and exclusion criteria. They were randomly allotted into two Group C (Conventional) n=30 receive Conventional Supraclavicular brachial plexus block Landmark guided. Group U (Ultrasound-guided) n=30 To receive Ultrasound-guided Supraclavicular brachial plexus block. Patients will be subjected to pre-anesthetic evaluation. Routine monitors will be connected (ECG, Automated NIBP, pulse oximeter).
Results: The mean value of perfusion index of the blocked limb in the USG group came to be 12.6 and the mean value of perfusion index of the blocked limb in the conventional Group came out to be 10.6, whereas that of the unblocked limb remained constant. The values were significant for the perfusion index of the blocked limb. In both groups, serial increases in perfusion index values were observed after successful blocks. In the Ultrasound group, the perfusion index value at 30 minutes increased to 12.6 from the baseline value of 3.13 while in the conventional group the value observed at 30 minutes was 10.7 in comparison to the baseline value of 2.47 the p values were significant.
Conclusion: The study demonstrated that the perfusion index is a useful and reliable tool in assessing the effectiveness of brachial plexus block.  It was found that the perfusion index is as effective as the conventional methods to assess the sensory and motor blockade and needed lesser patient cooperation and was less time consuming and hence superior to the conventional methods. A perfusion index ratio of more than or equal to 1.61 could be considered a cut-off to predict a successful peripheral nerve block.