2024, Vol. 7, Issue 4, Part A
Comparison and evaluation of perfusion index with two volumes of 0.75% ropivacaine with 4 milligrams of dexamethasone in supraclavicular brachial plexus block for upper limb surgeries under ultrasound guidance: A randomised clinical study
Author(s): Jumana Afrin U, Soundarya Murgesh Kalligudd, Prajwal Gowda C and Yoganarasimha N
Abstract:
Background: The Perfusion index (PI) is an objective tool used to assess successful nerve block. The blockade of sympathetic fibres after successful regional anaesthesia results in increased local blood flow and vasodilation, eventually increasing PI.
Aims: The objective is to analyse, contrast, and appraise the Perfusion index of the limb prior to and during the attainment of full motor block using 15ml and 20ml of 0.75% Ropivacaine with 4mg Dexamethasone in an ultrasound-guided supraclavicular brachial plexus block for upper limb procedures.
Materials and Methods: A randomised, single-blinded study was carried out in the Department of Anaesthesiology at BGS Global Institute of Medical Sciences between August 2022 and April 2023. A total of eighty patients, classified as ASA (American Society of Anaesthesiologists) I or II, and of any gender, who were undergoing upper limb procedures with US-guided Supraclavicular brachial plexus block, were included in the study. The patients were randomly assigned to two groups. Group I (n=40) received a 15ml dose of 0.75% Ropivacaine + 4mg Dexamethasone, whereas group II (n=40) received a 20ml dose of 0.75% Ropivacaine + 4mg Dexamethasone. The Perfusion Index (PI) was measured at the beginning of the experiment (before the block), every 2 minutes until 10 minutes, and then every 5 minutes until 30 minutes after the block. The PI ratio was determined by dividing the PI at 10 minutes by the baseline PI. The duration of pain relief and any observed adverse effects were recorded. The statistical analysis was conducted using SPSS version 21. Student's t-test and Chi-square test were conducted as required.
Results: The average age, sex ratio, and BMI were similar in both groups. In Group I, the average Perfusion index after 0 minutes was 1.72±0.58, whereas in Group II it was 1.59±0.58. After 10 minutes, the Perfusion index in Group I was 6.29±0.67, while in Group II it was 7.17±0.64. The mean perfusion ratio in Group I was 4.17±1.54, while in Group II it was 5.21±2.16. In group I, the duration of analgesia was 8.48±0.88 hours, but in group II it was 10±1.2 hours (p< 0.001). No negative consequences observed.
Conclusion: The perfusion index is a dependable indicator for evaluating the effectiveness of supraclavicular brachial plexus block using a small volume of 15ml of 0.75% Ropivacaine with 4mg Dexamethasone for procedures involving the upper limb. Nevertheless, there was a 15% reduction in the duration of pain relief when the volume of the Local Anaesthetic medication was decreased from 20 ml to 15 ml.
DOI: 10.33545/26643766.2024.v7.i4a.511
Pages: 41-46 | Views: 53 | Downloads: 23
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How to cite this article:
Jumana Afrin U, Soundarya Murgesh Kalligudd, Prajwal Gowda C, Yoganarasimha N. Comparison and evaluation of perfusion index with two volumes of 0.75% ropivacaine with 4 milligrams of dexamethasone in supraclavicular brachial plexus block for upper limb surgeries under ultrasound guidance: A randomised clinical study. Int J Med Anesthesiology 2024;7(4):41-46. DOI: 10.33545/26643766.2024.v7.i4a.511