To Evaluate the usefulness of a parameter called perfusion index in predicting the success of ultrasound guided nerve block for surgery

Not yet recruiting

Conditions: Medical and Surgical,

Registration Number: CTRI/2022/10/046369

Lead Sponsor: Premkumar D

Brief Summary: Brachial plexus block is a popular and widely employed regional nerve block technique for perioperative anaesthesia and analgesia for surgery of the upper extremity. The costoclavicular brachial plexus block (CCB) is a recently introduced infraclavicular approach that targets three cords located lateral to the axillary artery in the costoclavicular space .Cords in this space are located more superficially than with the classical approach at the lateral infraclavicular fossa and are clustered, while maintaining a consistent anatomical relationship with each other In addition, the costoclavicular space is considered a retrograde channel to the supraclavicular area, enabling reliable anaesthesia, including anaesthesia to the suprascapular nerve during shoulder surgery and providing additional stability in catheter placement for a continuous brachial plexus block .Because of these anatomical advantages, the CCB is emerging as a promising infraclavicular approach. Lignocaine 1% and Bupivacaine 0.5% mixture is used frequently for costoclavicular nerve block as it has early onset due to lignocaine and long duration of action due to bupivacaine from 3 to 6 h. The success of the peripheral nerve block is determined by the evaluation of sensory and motor functions. But these conventional methods (Pin-prick test and Modified Bromage Scale) are subjective, and they depend on patientâ€™s cooperation.Many objective methods like laser doppler perfusion imager (LDPI) ,skin electrical resistance, thermographic temperature measurement have been developed to evaluate block success, these are expensive and require special devicesPerfusion index (PI) is a simple, objective and noninvasive monitoring modality. It is the ratio of Pulsatile flow to Non pulsatile flow ,Pulsatile flow increases with sympathetic block in the nerve block ,hence perfusion index increases in a successful block .present study aims to evaluate the Change in perfusion index as an early objective tool to predict successful Ultrasonography guided costoclavicular block in patients posted for upper limb surgeries

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 100

Inclusion Criteria

1.American Society of Anaesthesiologist (ASA) class I and II.
2.BMI less than 29.9 Kg/M2.
3.Patients undergoing Upper limb surgeries.

Exclusion Criteria

1.Patient refusal to regional anaesthesia.
2.Anatomical abnormality at the site 3.Local infection at the site of puncture.
4.Patients having any coagulation abnormality 5.Patient having a known allergy to study drugs 6.Contralateral phrenic nerve palsy.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To test the Predictive accuracy of Perfusion index as an objective tool for the success of costoclavicular block.	Perfusion index values will be recorded every 2 minutes till 10 mins and then every 5 mins till 30 mins of the block.

Secondary Outcome Measures

Name	Time	Method
To compare the variations in Perfusion index value between successful and unsuccessful block.	Perfusion index values will be recorded every 2 minutes till 10 mins and then every 5 mins till 30 mins of the block.Data will be recorded for both successful and unsuccessful block , the variations of the perfusion index from the baseline will be measured.

Trial Locations

Locations (1): ESIC Medical College & PGIMSR
🇮🇳
Chennai, TAMIL NADU, India
ESIC Medical College & PGIMSR
🇮🇳Chennai, TAMIL NADU, India
Dr Premkumar D
Principal investigator
9566220405
d.premkumar.1993@gmail.com