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Perfusion Index Predicts the Effectiveness of Supraclavicular Brachial Plexus Block in Children Under General

Tiantian Chu1, Siqi Zhou1, Ting Peng1

  • 1Department of Anaesthesiology, Hubei Key Laboratory of Geriatric Anaesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anaesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

Anesthesiology Research and Practice
|March 3, 2025
PubMed

Insights

Perfusion index (PI) has limited ability to predict supraclavicular block (SCB) effectiveness in children under general anesthesia. However, PI may help guide pain management in the post-anesthesia care unit (PACU).

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Regional Anesthesia

Background:

  • Supraclavicular block (SCB) is used for pediatric upper extremity surgery.
  • Assessing SCB effectiveness under general anesthesia (sevoflurane or propofol) is crucial.
  • Perfusion index (PI) is a non-invasive measure from pulse oximetry.

Purpose of the Study:

  • To evaluate the predictive value of perfusion index (PI) for SCB effectiveness in children.
  • To compare PI's predictive ability under sevoflurane versus propofol anesthesia.
  • To assess PI's utility in guiding postoperative analgesia.

Main Methods:

  • Randomized controlled trial involving 103 pediatric patients undergoing upper extremity surgery.
  • Patients received either sevoflurane or propofol general anesthesia with SCB.
  • PI was measured using pulse oximetry at various time points.

Main Results:

  • PI increased post-anesthesia but showed no significant difference between anesthetic groups.
  • At 10 minutes post-SCB, PI was higher on the blocked side, but with low predictive sensitivity and specificity.
  • In the PACU, PI demonstrated higher sensitivity and specificity for predicting SCB effectiveness.

Conclusions:

  • PI has limited value in predicting immediate SCB effectiveness (10 min post-block) under general anesthesia.
  • PI may be a useful indicator for determining the need for supplemental analgesia in the PACU.
  • Further research could refine PI's role in guiding pain management post-SCB.

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