Evaluation of Ultrasound Guided Supraclavicular Block With Traditional Methods And Perfusion Index On Upper Extremity Surgeries

Introduction: Ultrasound (USG) guided supraclavicular blockin upper extremity surgery is a popular approach. In recentyears, many studies have been published on the perfusion index(PI) in the evaluation of block success. The main objective ofthis study is to evaluate the success and efficiency of thesupraclavicular block with traditional methods (Pin-prick test,Modified Bromage Scale) and perfusion index.Materials and Methods: After the approval of the ethicscommittee (2018-11/01) was taken for the study; 30 volunteerpatients who were 18-75 years old with American Society ofAnesthesiologists (ASA) I-II scores undergoing a hand,forearm, arm surgery, were included in the study. In thisprospective study; after ultrasound-guided supraclavicular blockhas been applied by injecting local anesthetic that consists ofprilocaine 12.5 ml + bupivacaine 12.5 ml to all patients, sensoryblock was checked with pin-prick test every 3 minutes, motorblock was checked by using modified Bromage scale every 2minutes, hemodynamic parameters and PI values were recordedevery 5 minutes. Times of motor block onset and total motorblock onset, sensory and motor block ending time, the durationof block technique, the time of first postoperative analgesiaconsumption and positivity time for pin-prick test wererecorded.Results: When the measured perfusion index values werecompared, the differences were significant. When we comparedthe PI values in pairs, the differences between basal and 5 thmin, 10th min, 15th min, 20th min, 25th min, and 30th min weresignificant. Positivity time for pin-prick test was 8.83 ± 2.70min (minimum 5 minutes and maximum 15 minutes), motorblock onset time was 6.7 ± 2.89 min (minimum 2 minutes andmaximum 13 minutes), time of total motor block onset was10.83 ± 3.07 min (minimum 6 minutes and maximum 19minutes). In the 5th minute PI values, an average increase of148% was observed compared to basal PI values.Conclusion: As a result; the supraclavicular block providedfaster sensory-motor block than other upper extremity blocks.It was concluded that the perfusion index was faster, moreobjective and simpler method than traditional methods inassessing the block success, due to vasodilatation that occurredbefore sensory and motor block.