末梢灌注指数评估臂丛神经阻滞的效果

目的 观察末梢灌注指数(tip perfusion index,TPI)的变化能否客观评估臂丛神经阻滞的效果.方法 臂丛神经阻滞下行上肢手术患者70例,ASA1～Ⅱ级,予以连续监测心电图、无创血压、双上肢脉氧饱和度和TPI,手术室温度控制在24℃～26℃2,阻滞前10 min静脉注射咪达唑仑0.06 mg/kg镇静,记...

The use of tip perfusion index to evaluate the effect of brachial plexus block

Objective To evaluate the availability of tip perfusion index (TPI) changes for objective prediction of successful inbrachial plexus block. Methods seventy ASA Ⅰ -Ⅱ patients scheduled for upper extremity operation under brachial plexus block were included. Noninvasive arterial blood pressure, electrocardiogram, bilateral upper extremity oxygen saturation and TPI values were measured. Operating room temperature was controlled at 24℃-26℃. Midazolam 0.06 mg/kg was given intravenously at 10 min before blockade. The onset time of analgesia in blocked upper limb and TPI values of bilateral upper limb were recorded. Results There was no change of TPI values in the unblocked upper limb after axillary/interscalene approach for brachial plexus block. In axillary approach for brachial plexus block group, TPI values in blocked upper limb started to increase as early as 8 min after the local anesthetic injection. In the interscalene approach for brachial plexus block group, TPI values in blocked upper limb started to increase as early as 6 min. The TPI values during a 30-min period in the failed block patients were not changed. Conclusion TPI provides a simple, early and noninvasive method to evaluate the effect of brachial plexus block