DETECTION OF SUCCESSFUL SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK BY PULSE OXIMETER PERFUSION INDEX

Abstract

Background: Early and accurate detection of failure of supraclavicular brachial plexus block helps to take early corrective measures and thus to save the operating room time and improve patient satisfaction. Aims: To assess the efcacy of perfusion index and perfusion index ratio in prediction of success or failure of brachial plexus block by supraclavicular approach. Methods: Ninety adult patients scheduled for upper limb surgery under supraclavicular brachial plexus block were recruited in this study. Success of brachial plexus was assessed by using traditional methods such as loss of pin prick and thermal sensation. Perfusion index and perfusion index ratio was monitored in both limbs at baseline, 3, 6, 9, 12, 15, 18 and, 21 minutes after block. Changes in PI and PI ratio were measured in successful as well as failure cases of brachial plexus block. Results: Signicant increase in perfusion index (1.60 Vs 7.65) and perfusion index ratio (1.00±0.00 Vs 4.78±2.7) was noticed following successful block. PI and PI ratio may be an important tool for early prediction of success rate of brachial plexus block. Failure or partial block was noticed in eight patients.