■灌注指数(PI)已被用作交感神经阻滞的替代标记。本研究评估了胸椎旁阻滞(PVB)和横突间阻滞(ITPB)后双侧上肢PI的变化。
■这项初步研究包括三组在全麻下使用PVB(n=11)或ITPB(n=10)进行择期单侧肺切除术的患者,或全身麻醉的泌尿外科手术(对照组,n=10)。在全身麻醉诱导后立即在T3-4,T5-6和T7-8肋间水平下使用10mL等分的0.5%罗哌卡因进行阻断。操作侧(PI-O)的PI值除以对侧(PI-CL),并评估相对于基线的变化(相对PI-O/PI-CL),50%的增长被认为是有意义的。
■在PVB和ITPB组中的所有情况下,阻断后观察到PI显著增加.中位数(1季度,3Q)术中相对PI-O/PI-CL值分别为0.9(0.8,1.4),2.1(1.4,2.5),和1.4(0.9,1.9)在控制中,PVB,和ITPB组(P=0.01),分别。配对比较显示仅在对照组和PVB组之间存在显着差异(调整后的P=0.01)。虽然对照组中的相对PI-O/PI-CL值通常保持接近1,但注意到偶尔波动超过1.5。
■PVB诱导了上肢PI的显著单侧增加,而ITPB往往导致不一致和较小程度的增加。监测PI值可以作为上肢交感神经阻滞的指标,但在手术过程中考虑影响这些观察结果的潜在混杂因素至关重要.需要进一步的研究来验证这些发现。
UNASSIGNED: Perfusion index (PI) has been used as a surrogate marker of sympathetic blockade. This study evaluated changes in PI of bilateral upper extremity after thoracic paravertebral block (PVB) and intertransverse process block (ITPB).
UNASSIGNED: This pilot study included three groups of patients undergoing elective unilateral pulmonary resection under general anesthesia with PVB (n=11) or ITPB (n=10), or urologic procedures with general anesthesia (control group, n=10). Blockades were performed using 10 mL aliquots of 0.5% ropivacaine administered at T3-4, T5-6, and T7-8 intercostal levels immediately after general anesthesia induction. The PI value of the operating side (PI-O) was divided by the contralateral side (PI-CL), and the relative change to baseline was assessed (relative PI-O/PI-CL), with a 50% increase considered meaningful.
UNASSIGNED: In all cases within the PVB and ITPB groups, a significant increase in PI was observed following the blockades. The median (1Q, 3Q) intraoperative relative PI-O/PI-CL values were 0.9 (0.8, 1.4), 2.1 (1.4, 2.5), and 1.4 (0.9, 1.9) in the control, PVB, and ITPB groups (P=0.01), respectively. Pairwise comparison revealed a significant difference only between the control and PVB groups (adjusted P=0.01). While the relative PI-O/PI-CL value in the control group generally remained close to 1, occasional fluctuations exceeding 1.5 were noted.
UNASSIGNED: PVB induced a noticeable unilateral increase in upper extremity PI, whereas ITPB tended to result in an inconsistent and lesser degree of increase. Monitoring PI values can serve as an indicator of upper extremity sympathetic blockade, but consideration of potential confounders impacting these observations during surgery is essential. Further research is needed to validate these findings.