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Evaluation of prediction effect of perfusion index for supraclavicular brachial plexus block in children: protocol
Jinxu Wang1, Lingli Deng1, Aijun Xu2
1Department of Anesthesiology and Pain Medicine, Tongji Hospital, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
Insights
Pulse perfusion index (PI) can help determine the success of supraclavicular brachial plexus block in children. This study investigated PI changes under sevoflurane or propofol anesthesia to assess nerve block effectiveness.
Area of Science:
- Pediatric Anesthesiology
- Regional Anesthesia
- Cardiovascular Monitoring
Background:
- Pulse perfusion index (PI) assesses blood flow but is under-researched in pediatric nerve blocks.
- Previous studies focused on awake adults or sacral blocks in children.
- The efficacy of PI in evaluating brachial plexus blocks in pediatric patients is not well-established.
Purpose of the Study:
- To evaluate the predictive effect of PI on the success of supraclavicular brachial plexus block (SCB) in pediatric patients.
- To compare PI changes in children under sevoflurane versus propofol general anesthesia.
- To determine if PI can reliably indicate nerve block success in pediatric patients.
Main Methods:
- A single-center, parallel-group, randomized superiority trial involving 104 children (1 month to 12 years).
- Patients were divided into sevoflurane or propofol anesthesia groups.
- PI was measured on blocked and non-blocked sides of the index and little fingers post-SCB.
Main Results:
- The study aims to provide evidence on PI changes following SCB in pediatric patients under different anesthetic agents.
- Investigate potential correlations between baseline PI and PI ratio 10 minutes after SCB.
- Analyze changes in mean arterial blood pressure (MAP) and heart rate (HR).
Conclusions:
- This trial will elucidate PI's role in assessing SCB effectiveness in pediatric anesthesia.
- Changes in PI may help determine nerve block success, independent of anesthetic effects.
- Findings could improve monitoring and assessment of regional anesthesia in children.
Background:
Pulse perfusion index (PI) reflects blood perfusion. It has been reported that PI can be used to evaluate the effect of nerve block, but currently, it is mainly focused on awake adults. In pediatric general anesthesia, it has been reported that PI can evaluate the effect of the sacral block. Still, there is a lack of relevant research on the impact of brachial plexus blocks. Our objective is to assess the prediction effects of PI on the success of supraclavicular brachial plexus block in pediatric patients under sevoflurane or propofol general anesthesia.
Methods/Design:
This is a mono-center, parallel, 2-arm randomized superiority trial. One hundred four children aged 1 month to 12 years who undergo upper limb surgery will be enrolled in this study. According to anesthesia induction and maintenance medication, they will be divided into sevoflurane and propofol groups. The PI values of the index and little finger will be recorded on the blocked and non-blocked sides of supraclavicular brachial plexus block (SCB) in all children. The primary outcome is to assess the effects of PI on the success of supraclavicular brachial plexus block in pediatric patients under sevoflurane or propofol general anesthesia. The secondary outcome includes mean arterial blood pressure (MAP), heart rate (HR), and correlation between baseline PI and 10 min after SCB (PI ratio).
Discussion:
This trial will provide evidence on the changes in PI after SCB in sevoflurane or propofol anesthesia in children. SCB may lead to changes in PI values under sevoflurane or propofol anesthesia. After the children wake up at the end of the surgery, the changes in PI values on the block side and non-block side may be helpful to judge the effect of nerve block when excluding the influence of anesthetics.
Trial Registration:
ClinicalTrials.gov NCT04216823 . Registered on 15 July 2020.
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