■成功的臂丛神经阻滞产生交感神经阻滞,导致阻塞段的皮肤温度升高。本研究旨在评估红外热成像预测节段性锁骨上臂丛神经阻滞失败的准确性。
■这项前瞻性观察性研究包括接受锁骨上臂丛神经阻滞下上肢手术的成年患者。感觉是在尺骨的皮区分布进行评估,中位数,和桡神经.块失败定义为在块完成后30分钟没有完全感觉损失。通过尺骨皮肤供应的红外热成像评估皮肤温度,中位数,基线时的桡神经,块完成后5、10、15和20分钟。计算每个时间点的基线测量的温度变化。结果是使用受试者工作特征曲线(AUC)分析下的面积,每个部位的温度变化预测相应神经阻滞失败的能力。
■80名患者可用于最终分析。5分钟时温度变化能力的AUC(95%置信区间[CI])预测尺骨失败,中位数,radial神经阻滞为0.79(0.68-0.87),0.77(0.67-0.86),和0.79(0.69-0.88)。AUC(95%CI)逐渐增加,并在15分钟时达到最大值(尺神经0.98[0.92-1.00],正中神经0.97[0.90-0.99],radial神经0.96[0.89-0.99]),阴性预测值为100%。
■不同皮肤段的红外热成像为预测锁骨上臂丛神经阻滞失败提供了准确的工具。在每个节段处增加的皮肤温度可以100%准确度地排除相应神经中的阻滞失败。
UNASSIGNED: Successful brachial plexus blockade produces sympathetic blockade, resulting in increased skin temperature in the blocked segments. This
study aimed to evaluate the accuracy of infrared thermography in predicting failed segmental supraclavicular brachial plexus block.
UNASSIGNED: This prospective observational
study included adult patients undergoing upper-limb surgery under supraclavicular brachial plexus block. Sensation was evaluated at the dermatomal distribution of the ulnar, median, and radial nerves. Block failure was defined as absence of complete sensory loss 30 min after block completion. Skin temperature was evaluated by infrared thermography at the dermatomal supply of the ulnar, median, and radial nerves at baseline, 5, 10, 15, and 20 min after block completion. The temperature change from the baseline measurement was calculated for each time point. Outcomes were the ability of temperature change at each site to predict failed block of the corresponding nerve using area under receiver-operating characteristic curve (AUC) analysis.
UNASSIGNED: Eighty patients were available for the final analysis. The AUC (95% confidence interval [CI]) for the ability of temperature change at 5 min to predict failed ulnar, median, and radial nerve block was 0.79 (0.68-0.87), 0.77 (0.67-0.86), and 0.79 (0.69-0.88). The AUC (95% CI) increased progressively and reached its maximum values at 15 min (ulnar nerve 0.98 [0.92-1.00], median nerve 0.97 [0.90-0.99], radial nerve 0.96 [0.89-0.99]) with negative predictive value of 100%.
UNASSIGNED: Infrared thermography of different skin segments provides an accurate tool for predicting failed supraclavicular brachial plexus block. Increased skin temperature at each segment can exclude block failure in the corresponding nerve with 100% accuracy.