open access

Vol 49, No 1 (2017)
Original and clinical articles
Published online: 2017-02-19
Submitted: 2016-04-24
Accepted: 2016-12-18
Get Citation

Is the change of percutaneous oxygen pressure available to judge the effects of brachial plexus block?

Tomoki Nishiyama
DOI: 10.5603/AIT.a2017.0003
·
Pubmed: 28215043
·
Anaesthesiol Intensive Ther 2017;49(1):53-56.

open access

Vol 49, No 1 (2017)
Original and clinical articles
Published online: 2017-02-19
Submitted: 2016-04-24
Accepted: 2016-12-18

Abstract

BACKGROUND: To know the objective methods of the effects of the brachial plexus block, we studied the changes in percutaneous oxygen pressure (tcPO2) with the hypothesis that tcPO2 increases significantly on the blocked arm in comparison with the non-blocked arm, a phenomenon which is connected with vasodilation following the brachial plexus block.

METHODS: Fifteen patients scheduled for upper extremity surgery, aged 20 to 70 years, with ASA physical status I or II were included. Before anaesthesia, the electrodes used to measure tcPO2 were put on the radial side of the forearm and upper arm of both the right and left sides (a total of 4 electrodes). Oxygen at 6 L min-1 was administered by a facial mask. Once midazolam 1–2 mg and fentanyl 50 μg had been administered intravenously, a propofol infusion was started at a dose of 2 mg kg-1 h-1. The interscalene block was performed by means of a nerve stimulator, using 20 mL of 1% lidocaine solution combined with 20 mL of 0.75% ropivacaine solution. TcPO2 was measured just before the block and 30 minutes after the block.

RESULTS: TcPO2 in both forearm and upper arm significantly increased after the block in both sides namely, blocked and non-blocked. No difference was observed in tcPO2 between the blocked side and non-blocked side.

CONCLUSION: Changes of tcPO2 are not useful in order to assess the effects of the interscalene block under oxygen administration.

Abstract

BACKGROUND: To know the objective methods of the effects of the brachial plexus block, we studied the changes in percutaneous oxygen pressure (tcPO2) with the hypothesis that tcPO2 increases significantly on the blocked arm in comparison with the non-blocked arm, a phenomenon which is connected with vasodilation following the brachial plexus block.

METHODS: Fifteen patients scheduled for upper extremity surgery, aged 20 to 70 years, with ASA physical status I or II were included. Before anaesthesia, the electrodes used to measure tcPO2 were put on the radial side of the forearm and upper arm of both the right and left sides (a total of 4 electrodes). Oxygen at 6 L min-1 was administered by a facial mask. Once midazolam 1–2 mg and fentanyl 50 μg had been administered intravenously, a propofol infusion was started at a dose of 2 mg kg-1 h-1. The interscalene block was performed by means of a nerve stimulator, using 20 mL of 1% lidocaine solution combined with 20 mL of 0.75% ropivacaine solution. TcPO2 was measured just before the block and 30 minutes after the block.

RESULTS: TcPO2 in both forearm and upper arm significantly increased after the block in both sides namely, blocked and non-blocked. No difference was observed in tcPO2 between the blocked side and non-blocked side.

CONCLUSION: Changes of tcPO2 are not useful in order to assess the effects of the interscalene block under oxygen administration.

Get Citation

Keywords

brachial plexus block, interscalene block; brachial plexus blockade, efficacy; percutaneous oxygen pressure

About this article
Title

Is the change of percutaneous oxygen pressure available to judge the effects of brachial plexus block?

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 1 (2017)

Pages

53-56

Published online

2017-02-19

DOI

10.5603/AIT.a2017.0003

Pubmed

28215043

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(1):53-56.

Keywords

brachial plexus block
interscalene block
brachial plexus blockade
efficacy
percutaneous oxygen pressure

Authors

Tomoki Nishiyama

References (17)
  1. Galvin EM, Niehof S, Medina HJ, et al. Thermographic temperature measurement compared with pinprick and cold sensation in predicting the effectiveness of regional blocks. Anesth Analg. 2006; 102(2): 598–604.
  2. Lehtipalo S, Winsö O, Koskinen LO, et al. Cutaneous sympathetic vasoconstrictor reflexes for the evaluation of interscalene brachial plexus block. Acta Anaesthesiol Scand. 2000; 44(8): 946–952.
  3. Thomas PS, Hakim TS, Trang LQ, et al. The synergistic effect of sympathectomy and hyperbaric oxygen exposure on transcutaneous PO2 in healthy volunteers. Anesth Analg. 1999; 88(1): 67–71.
  4. Wenger CB, Stephenson LA, Durkin MA. Effect of nerve block on response of forearm blood flow to local temperature. J Appl Physiol (1985). 1986; 61(1): 227–232.
  5. Kus A, Gurkan Y, Gormus SK, et al. Usefulness of perfusion index to detect the effect of brachial plexus block. J Clin Monit Comput. 2013; 27(3): 325–328.
  6. Iskandar H, Wakim N, Benard A, et al. The effects of interscalene brachial plexus block on humeral arterial blood flow: a Doppler ultrasound study. Anesth Analg. 2005; 101(1): 279–81, table of contents.
  7. Ebert B, Braunschweig R, Reill P. [Quantification of variations in arm perfusion after plexus anesthesia with color doppler sonography]. Anaesthesist. 1995; 44(12): 859–862.
  8. Nishiyama T. Changes in percutaneous oxygen tension induced by spinal anesthesia. J Anesth. 2007; 21(3): 317–319.
  9. Li J, Karmakar MK, Li X, et al. Regional hemodynamic changes after an axillary brachial plexus block: a pulsed-wave Doppler ultrasound study. Reg Anesth Pain Med. 2012; 37(1): 111–118.
  10. Bergek C, Zdolsek JH, Hahn RG. Non-invasive blood haemoglobin and plethysmographic variability index during brachial plexus block. Br J Anaesth. 2015; 114(5): 812–817.
  11. Lima AP, 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): 1210–1213.
  12. Galvin EM, Niehof S, Verbrugge SJc, et al. Peripheral flow index is a reliable and early indicator of regional block success. Anesth Analg. 2006; 103(1): 239–43, table of contents.
  13. Cross GD, Porter JM. Blood flow in the upper limb during brachial plexus anaesthesia. Anaesthesia. 1988; 43(4): 323–326.
  14. Bridenbaugh PO, Moore DC, Bridenbaugh LD. Alterations in capillary and venous blood gases after regional-block anesthesia. Anesth Analg. 1972; 51(2): 280–286.
  15. Lumenta DB, Haslik W, Beck H, et al. Influence of brachial plexus blockade on oxygen balance during surgery. Anesth Analg. 2011; 113(1): 199–201.
  16. Larsen VH, Treschow M. Venous blood gas analysis for evaluation of blood circulation of the hand during continuous axillary block. Acta Anaesthesiol Scand. 1995; 39(4): 554–556.
  17. Fujimura N, Namba H, Tsunoda K, et al. Effect of hemidiaphragmatic paresis caused by interscalene brachial plexus block on breathing pattern, chest wall mechanics, and arterial blood gases. Anesth Analg. 1995; 81(5): 962–966.

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