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ASSESSMENT OF SKIN TEMPERATURE CHANGE BY PASSIVE INFRARED THERMOGRAPHY IN THE PERIPHERAL NERVE TERRITORIES FOLLOWING ULTRASOUND GUIDED INTERSCALENE BLOCK
ESRA Academy. Mathers J. Sep 9, 2016; 138387; 0228 Topic: Upper Limb Blocks - Brachial Plexus Block
Dr. Jonathan Mathers
Dr. Jonathan Mathers

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Abstract
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Background and Aims:

Objective assessment of peripheral nerve blocks remains elusive. Where deeper sedation for block performance is used or in those patients with communication difficulties the reliability of patient dependent assessment tools can become impaired.

Skin temperature change occurs where sympathetic blockade from plexus blocks allows movement of blood from the deeper tissues to the skin and this can be measured non-invasively using a thermal camera.

Our aim was to assess the degree and nature of skin temperature change following ultrasound guided interscelene brachial plexus block

Methods:

Following REB approval and informed, written consent, 24 patients were prospectively enrolled into the study. Temperature readings were taken by TM using an FLIR i7 thermal camera. Temperature readings were taken in the median, ulnar, radial, musculocutaneous territories and also in the C5 deltoid area every 5 minutes in both arms. The block was performed using 30ml of 0.66% Ropivacaine as is routine practice in our institution.

Results:

All patients received a successful interscalene block as assessed by numbness in the territory of the lateral deltoid combined with inability to extend or abduct at the shoulder.

65% of patients demonstrated a significant temperature change and the median temperature change was 2 degrees centigrade or greater. However 35% of patients displayed little to no temperature change in any territory.

Conclusions:

Temperature change remains a recognised method of assessing peripheral block function for the sciatic nerve and brachial plexus block at the supraclavicular, infraclavicular and axillary level but we were unable to demonstrate clear efficacy at the interscalene level.

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