ESRA Academy. Del Buono R. Sep 8, 2016; 138473; 0331 Topic: EQUIPMENT FOR BLOCK PERFORMANCE
Disclosure(s): Nothing to disclose.
Romualdo Del Buono
Romualdo Del Buono

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Background and Aims:

In 1995 was introduced the Perfusion Index (PI), a value that notices about the saturation value’s reliability. In literature there are studies that correlate the PI with external influences: pain, stress hormones, blood losses. There are also studies that demonstrated a PI increase after brachial plexus block. We assumed that a PI increase is a predictor of a successful nerve block.


With this assumption, we measured the PI on 20 patients scheduled for limb surgery in regional anesthesia (10 sciatic nerve blocks, 2 spinals, 8 brachial plexus blocks). PI values were noted before and after regional anesthesia, being careful to place the pulseoximeter on the limb where the block is performed.


A positive correlation between the PI and block effectiveness has been noticed in 18 patients, where the PI increase (usually 2-3 times bigger than the basal PI within the first 10 minutes) was observed before tactile and motor loss. A lower increase has been noticed instead when a low volume interscalene brachial plexus block was performed, despite block efficacy.


This observation follows the previous studies on the PI's modifications after brachial plexus block, but involves also the lower limbs. Further data are required to validate this intuition of PI as a predictive instrument for block efficacy assessment. We are about to start a trial assuming that a PI doubling within 5 minutes is a predictor of block efficacy; we think it could be a useful tool to reduce the block volume.

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