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Purpose: Infraclavicular block (ICB) and interscalene block (ISB) accompanied by ultrasonography imaging (USI) are the most frequently used brachial plexus block techniques in upper extremity surgeries. It is already known that sympathetic blockage occurs after the application of these blocks, and blood flow increases with vasodilatation caused by the blockage. This study aimed to compare the effect of ICB and ISB, which are applied together with USI, on forearm tissue oxygenation. Materials and Methods: A hundred-four patients were included in this study belonging to ASA I-III risk groups, aged 18–65 years, who were scheduled for elective or emergency arm, elbow, or forearm surgery. The patients were divided into two groups: Group ICB and Group ISB. In addition to the baseline hemodynamic measurements, PI, time average velocity (TAV), brachial artery diameter (BAD), brachial arterial area (BAA), brachial artery beat flow (BF), and tissue oxygen saturation (rSO2) data were recorded before block and at the 10th, 20th, and 30th min after the block was completed. Results: The demographic data of the patients in the Group ICB and Group ISB were compared, no significant differences were detected between the groups. When the distribution of the percentage increase in PI and rSO2 values according to time was examined, significant differences were found between the groups. There were no significant differences in the percentage increases in BF, TAV, BAA, and BAD values between the 0th minute and at 10th, 20th, and 30th min (p>0.05). Horner syndrome was observed in 8 patients (15%) and sudden hoarseness was observed in 3 patients (5%) in Group ISB. No complications developed in the Group ICB. Conclusion: This study shows that the effects of ICB and ISB on forearm tissue oxygenation were compared and it was found that ICB increased rSO2 and PI values.

Introduction:The aim of this study is to the usefulness of the perfusion index to predict mortality in the pediatric intensive care unit.Methods:The study included patients aged >28 days and

Aim:As we know, the perfusion index (PI) increases in nerve blocked areas in regional anesthesia and this is used to predict successful intervention, we hypothesized that, in neonatal brachial plexus palsy (NBPP), PI may alter in the affected arm.Materials and Methods:Prospectively, 11 patients with defective Moro reflex diagnosed as NBPP were included in this study. Their demographic data were collected and perfusion indices were measured from both the affected and non-affected limbs in the 24th hour of postnatal life. These measurements were statistically compared. The increased rate of PI was also calculated and the increment of PI in patients with and without clavicle fracture was compared.Results:PI values were statistically higher in affected extremities compared to not-affected extremities (mean ± standard deviation, 2.47±0.74, 1.83±0.66 respectively, p=0.0003). There was no difference in patients with or without clavicle fracture.Conclusion:In the future, PI may be evaluated as a prognostic factor for neurologic dysfunction in NBPP and be used as a predictor for early surgical intervention.

Objective: We aimed the comparison between traditional methods and perfusion index (PI) on evaluating the block success and sufficiency of interscalene block that we applied to shoulder surgery cases by using ultrasonography (USG) and peripheric nerve stimulator or only peripheric nerve stimulator only. Material and Methods: After ethics committee and patient approvals; ASA I-III, 50 adult patients (18-70 ages) who underwent shoulder, arm surgery were allocated to this prospective research. Interscalene block was applied to all patients by using USG and peripheric nerve stimulation or peripheric nerve stimulation with bupivacaine 0.5% 1 mg/kg+prilocaine 2% 4 mg/kg+NaCl 0.9% to complete the anesthetic solution to 30 mlt. We recorded heart rate, mean arterial pressure, peripheric oxygen saturation, PI, motor block times and pin-prick test values of the patients. Results: When the PI values of the patients on different times were compared, the difference between the groups was insignificant. Loss of cold sensation time was 10.3±3.9 min in Group 1 and 11.3±4.3 min in Group 2. Pin-prick test time to be positive was 16.3±3.8 min in Group 1 and 17.6±5.1 min in Group 2. Motor block onset time was 14.2±3.7 min in Group 1 and 16.1±4.3 min in Group 2. Conclusion: Using USG enables us to benefit from local anesthetic more effectively and to encounter fewer complications. Another conclusion can be about PI parameters which significantly increase with block success in time within the groups. So, PI can be used due to being easily applicable and non-invasive technique for predicting the block success. [ABSTRACT FROM AUTHOR]

Background: Different positions given for the surgical procedure can cause changes in tissue perfusion and cardiac output. In this study, we aimed to investigate the changes of pleth variability index (PVI), perfusion index (PI) and noninvasive continuous cardiac output measurement method (EscCO) in different surgical positions in participants with spontaneous breathing. Materials and Methods: A sample of 20 healthy individuals was included in the prospective observational this study. Participants held six different positions: supine, prone, 30 degrees upside, 45 degrees upside, trendelenburg (20-degrees head down), and reverse trendelenburg (20-degrees head up). The time was kept 10 minutes between each position. Before each position change, volunteers were placed in the supine position and after five minutes of rest, a new position was given. After the position change, PI, PVI, EscCO, peripheral capillary oxygen saturation values at 5th minutes were recorded. Results: No statistically significant difference was found in PI, PVI and EscCO values measured while the participants were in different positions (p >0.05). Conclusion: This study revealed that PI, PVI and EscCO did not change in all surgical positions, and this parameters were not affected by position in young healthy individuals with spontaneous breathing. [ABSTRACT FROM AUTHOR]

Objective: Patient position and pneumoperitoneum during laparoscopic surgery effect hemodynamic parameters by changing intrathoracic pressure. The aim of the study is to investigate the effect of reverse Trendelenburg position and pneumoperitoneum on perfusion index (PI) and Pleth variability index (PVI) during laparoscopic surgery. Method: Seventy-five patients who would undergo elective laparoscopic cholecystectomy under general anaesthesia for cholelithiasis in two centres were recruited in this prospective observational study. Respiratory and hemodynamic parameters, PI and PVI values were recorded prior and after the anaesthesia induction, during reverse Trendelenburg position, during pneumoperitoneum and after deflation. Results: Due to haemodynamic instability that required treatment 7 patients were excluded from the study. PI values increased after general anesthesia induction (P<0.001) but PVI values didn't change significantly (P>0,05). No significant change is observed in PI values with the patient position and pneumoperitoneum. PVI values measured in reverse Trendelenburg position and pneumoperitoneum were higher than post-intubation values (P<0,05) and post-deflation values were similar to baseline values (P>0,05). Conclusion: PI values increase, but PVI is not affected during general anaesthesia. Reverse Trendelenburg position and pneumoperitoneum do not cause a change in PI values, whereas PVI values increase. These changes should be taken into consideration when fluid management is done by PI and PVI monitoring during surgeries in patients who undergo pneumoperitoneum or operated in reverse Trendelenburg position. [ABSTRACT FROM AUTHOR]

Objective: Recently, there are many researches about perfusion index which is measured by using pulse oximetry technology for evaluating the efficiency of peripheric nerve block. In this research; we aimed the evaluation between perfusion index and conventional methods about evaluating the success and efficiency of ultrasound guided infraclavicular block which was made on patients who had upper limb surgery. Material and Methods: 30 patients at the age of between 18-70 who will have a surgery of hand, forearm, arm by Orthopedics and Traumatology Department in American Society of Anesthesiologists I-II groups are taken into this research after the patient's and ethics committee's approval are taken. Our research was made as prospective. Ultrasound guided lateral sagittal infraclavicular block was applied to all patients with local anesthetic solution which was prepared as; 1 mg/kg 0.5% bupivakain+5 mg/kg 2% prilokain+NaCl 0.9% until reaching the solution limit of 45 cc. Basal values of heart rate, mean arterial pressure, peripheric oxygen saturation, perfusion index, cold sensory loss test, Pin-prick test and distal skin temperature and the values at the minutes of 5th, 10th, 15th, 20th, 25th, 30th are recorded. Results: When we compare the perfusion index values of the patients in research which were measured at different times, the difference was significant. When the measurements were compared as in double, differences between basal and 5th, 10th, 15th, 20th, 25th, 30th were significant. Time of cold sensory loss was 13.16±3.39 minutes (min 10 and max 25 minutes). Time of Pin-prick test positivity was 15.00± 4.23 minutes (min 10 and max 30 minutes). Motor block onset time was 10.66±3.40 minutes (min 5 and max 20 minutes). Conclusion: In this research; we showed that pulse-oximetry perfusion index can rapidly reveal the perfusion increase which is reasoned by sympathetic block that occurs after infraclavicular block and before sensory and motor block. It is concluded that it is a sensitive and simple method which can be used with traditional methods. [ABSTRACT FROM AUTHOR]