Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee Arthroplasty
Background: The perfusion index (PI) is an objective method used to determine a successful nerve block. This study aimed to investigate the prognostic ability of the PI for a successful adductor canal nerve block (ACB) and suggest the optimal PI cut-off value for predicting a block. Methods: This st...
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MDPI AG
2023-09-01
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| Online Access: | https://www.mdpi.com/2075-1729/13/9/1865 |
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| author | Hye Joo Yun Joong Baek Kim Hyun Sik Chung |
| author_facet | Hye Joo Yun Joong Baek Kim Hyun Sik Chung |
| author_sort | Hye Joo Yun |
| collection | DOAJ |
| description | Background: The perfusion index (PI) is an objective method used to determine a successful nerve block. This study aimed to investigate the prognostic ability of the PI for a successful adductor canal nerve block (ACB) and suggest the optimal PI cut-off value for predicting a block. Methods: This study was a prospective observational study and enrolled a total of 39 patients. The patients were dichotomized into successful and inappropriate ACB groups according to the results of the sensation tests. The PI value, Pleth variability index (PVi) value, and heart rate were recorded one minute before the block, at the time of the block, and one to 30 min after the block at one-minute intervals. Delta (dPI), which was defined as the difference in PI value from the baseline (the value one minute before the block), was the primary outcome. The area under the receiver operating characteristic curve (AUROC) was calculated to determine the dPI prognostic accuracy and optimal cut-off value. Results: Successful ACB was achieved in 33 patients, while ACB was inappropriate in six patients. The dPI showed significant differences between the two groups under the time interval measured (<i>p</i> = 0.001). The dPI at 5 and 20 min showed good prognostic ability for a successful block, with optimal cut-off values of 0.33 (AUROC: 0.725, 95% CI 0.499–0.951) and 0.64 (AUROC: 0.813, 95% CI 0.599–1.000), respectively. Conclusions: The dPI is an effective predictor of successful ACB. The suggested dPI cut-off values at 5 and 20 min were below 0.33 and 0.64, respectively. |
| first_indexed | 2024-03-10T22:32:38Z |
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| language | English |
| last_indexed | 2024-03-10T22:32:38Z |
| publishDate | 2023-09-01 |
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| spelling | doaj.art-0fd28d0153684b5ba01892a30276f7282023-11-19T11:37:22ZengMDPI AGLife2075-17292023-09-01139186510.3390/life13091865Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee ArthroplastyHye Joo Yun0Joong Baek Kim1Hyun Sik Chung2Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of KoreaBackground: The perfusion index (PI) is an objective method used to determine a successful nerve block. This study aimed to investigate the prognostic ability of the PI for a successful adductor canal nerve block (ACB) and suggest the optimal PI cut-off value for predicting a block. Methods: This study was a prospective observational study and enrolled a total of 39 patients. The patients were dichotomized into successful and inappropriate ACB groups according to the results of the sensation tests. The PI value, Pleth variability index (PVi) value, and heart rate were recorded one minute before the block, at the time of the block, and one to 30 min after the block at one-minute intervals. Delta (dPI), which was defined as the difference in PI value from the baseline (the value one minute before the block), was the primary outcome. The area under the receiver operating characteristic curve (AUROC) was calculated to determine the dPI prognostic accuracy and optimal cut-off value. Results: Successful ACB was achieved in 33 patients, while ACB was inappropriate in six patients. The dPI showed significant differences between the two groups under the time interval measured (<i>p</i> = 0.001). The dPI at 5 and 20 min showed good prognostic ability for a successful block, with optimal cut-off values of 0.33 (AUROC: 0.725, 95% CI 0.499–0.951) and 0.64 (AUROC: 0.813, 95% CI 0.599–1.000), respectively. Conclusions: The dPI is an effective predictor of successful ACB. The suggested dPI cut-off values at 5 and 20 min were below 0.33 and 0.64, respectively.https://www.mdpi.com/2075-1729/13/9/1865perfusion indexperipheral nerve blockpostoperative analgesiaknee arthroplastyultrasonography |
| spellingShingle | Hye Joo Yun Joong Baek Kim Hyun Sik Chung Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee Arthroplasty Life perfusion index peripheral nerve block postoperative analgesia knee arthroplasty ultrasonography |
| title | Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee Arthroplasty |
| title_full | Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee Arthroplasty |
| title_fullStr | Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee Arthroplasty |
| title_full_unstemmed | Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee Arthroplasty |
| title_short | Predictive Ability of Perfusion Index for Determining the Success of Adductor Canal Nerve Block for Postoperative Analgesia in Patients Undergoing Unilateral Total Knee Arthroplasty |
| title_sort | predictive ability of perfusion index for determining the success of adductor canal nerve block for postoperative analgesia in patients undergoing unilateral total knee arthroplasty |
| topic | perfusion index peripheral nerve block postoperative analgesia knee arthroplasty ultrasonography |
| url | https://www.mdpi.com/2075-1729/13/9/1865 |
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