Affiliation:
1. Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
Abstract
Background: The perfusion index (PI) is an objective method used to determine a successful nerve block. This study aimed to investigate the prognostic ability of the PI for a successful adductor canal nerve block (ACB) and suggest the optimal PI cut-off value for predicting a block. Methods: This study was a prospective observational study and enrolled a total of 39 patients. The patients were dichotomized into successful and inappropriate ACB groups according to the results of the sensation tests. The PI value, Pleth variability index (PVi) value, and heart rate were recorded one minute before the block, at the time of the block, and one to 30 min after the block at one-minute intervals. Delta (dPI), which was defined as the difference in PI value from the baseline (the value one minute before the block), was the primary outcome. The area under the receiver operating characteristic curve (AUROC) was calculated to determine the dPI prognostic accuracy and optimal cut-off value. Results: Successful ACB was achieved in 33 patients, while ACB was inappropriate in six patients. The dPI showed significant differences between the two groups under the time interval measured (p = 0.001). The dPI at 5 and 20 min showed good prognostic ability for a successful block, with optimal cut-off values of 0.33 (AUROC: 0.725, 95% CI 0.499–0.951) and 0.64 (AUROC: 0.813, 95% CI 0.599–1.000), respectively. Conclusions: The dPI is an effective predictor of successful ACB. The suggested dPI cut-off values at 5 and 20 min were below 0.33 and 0.64, respectively.
Subject
Paleontology,Space and Planetary Science,General Biochemistry, Genetics and Molecular Biology,Ecology, Evolution, Behavior and Systematics
Reference44 articles.
1. Peripheral nerve blocks in the management of postoperative pain: Challenges and opportunities;Joshi;J. Clin. Anesth.,2016
2. Adductor canal block versus femoral nerve block and quadriceps strength: A randomized, double-blind, placebo-controlled, crossover study in healthy volunteers;Jaeger;Anesthesiology,2013
3. Influence of early mobilization program on pain, self-reported and performance based functional measures following total knee replacement;Harikesavan;J. Clin. Orthop. Trauma,2019
4. Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty: A randomized, double-blind study;Zaric;Reg. Anesth. Pain. Med.,2013
5. Review on Nerve Blocks Utilized for Perioperative Total Knee Arthroplasty Analgesia;Hasegawa;Orthop. Rev.,2022