Comparison of the Block Characteristics of Ultrasound Guided Costoclavicular and Infraclavicular Block With the Perfusion Index

Peripheral nerve block is to anesthetize the dermatomes belonging to the nerve or nerve group to which the block is applied, by performing sympathetic, sensory and motor blocks. Brachial plexus blockade; It is a peripheral nerve blockage that can be used in surgical operations to be performed on the upper extremity and can be performed at the level of interscalene, supraclavicular, infraclavicular, costoclavicular, axillary and terminal nerves.

The costoclavicular brachial plexus block has been used as an alternative to lateral sagittal infraclavicular block, due to its ease of application, its rapid onset of action and its high success rate. The effectiveness of the block is measured by sensory, motor and sympathetic block effects. The sensory block can be evaluated by cold or pinprick test, and motor block by traditional methods such as the patient's response to verbal commands and can be objective.

Sympathetic block manifests itself with vasodilation and an increase in blood flow rate and can be measured with the more quantitative perfusion index (PI). The perfusion index represents the ratio of pulsatile blood flow to static blood flow in peripheral tissue and can be measured continuously and noninvasively from a pulse oximeter. Successful peripheral nerve blockade; It is seen as local vasodilation, increased local blood flow, some increase in skin temperature and loss of sensation in the extremity due to the blockage of sympathetic fibers. It can be a guide in determining the effectiveness of the block because it is noninvasive and easy, providing rapid evaluation, without requiring patient cooperation to evaluate the success of the block.