L’évaluation ‘à coup d’œil’ des motifs thermographiques pour prédire la réussite d’un bloc infraclaviculaire latéral

TY - JOUR

T1 - L’évaluation ‘à coup d’œil’ des motifs thermographiques pour prédire la réussite d’un bloc infraclaviculaire latéral

AU - Andreasen, Asger M.

AU - Linnet, Karen E.

AU - Asghar, Semera

AU - Rothe, Christian

AU - Rosenstock, Charlotte V.

AU - Lange, Kai H.W.

PY - 2017/11

Y1 - 2017/11

N2 - Purpose: Increased distal skin temperature can be used to predict the success of lateral infraclavicular (LIC) block. We hypothesized that an “eyeball test” of specific infrared thermographic patterns after LIC block could be used to determine block success. Methods: In this observational study, five observers trained in four distinct thermographic patterns independently evaluated thermographic images of the hands of 40 patients at baseline and at one-minute intervals for 30 min after a LIC block. Sensitivity, specificity, and predictive values of a positive and a negative test were estimated to evaluate the validity of specific thermographic patterns for predicting a successful block. Sensory and motor block of the musculocutaneous, radial, ulnar, and median nerves defined block success. Fleiss’ kappa statistics of multiple interobserver agreements were used to evaluate reliability. Results: As a diagnostic test, the defined specific thermographic patterns of the hand predicted a successful block with increasing accuracy over the 30-min observation period. Block success was predicted with a sensitivity of 92.4% (95% confidence interval [CI], 86.8 to 96.2) and with a specificity of 84.0% (95% CI, 70.3 to 92.4) at min 30. The Fleiss’ kappa for the five observers was 0.87 (95% CI, 0.77 to 0.96). Conclusion: We conclude that visual evaluation by an eyeball test of specific thermographic patterns of the blocked hands may be useful as a valid and reliable diagnostic test for predicting a successful LIC block.

AB - Purpose: Increased distal skin temperature can be used to predict the success of lateral infraclavicular (LIC) block. We hypothesized that an “eyeball test” of specific infrared thermographic patterns after LIC block could be used to determine block success. Methods: In this observational study, five observers trained in four distinct thermographic patterns independently evaluated thermographic images of the hands of 40 patients at baseline and at one-minute intervals for 30 min after a LIC block. Sensitivity, specificity, and predictive values of a positive and a negative test were estimated to evaluate the validity of specific thermographic patterns for predicting a successful block. Sensory and motor block of the musculocutaneous, radial, ulnar, and median nerves defined block success. Fleiss’ kappa statistics of multiple interobserver agreements were used to evaluate reliability. Results: As a diagnostic test, the defined specific thermographic patterns of the hand predicted a successful block with increasing accuracy over the 30-min observation period. Block success was predicted with a sensitivity of 92.4% (95% confidence interval [CI], 86.8 to 96.2) and with a specificity of 84.0% (95% CI, 70.3 to 92.4) at min 30. The Fleiss’ kappa for the five observers was 0.87 (95% CI, 0.77 to 0.96). Conclusion: We conclude that visual evaluation by an eyeball test of specific thermographic patterns of the blocked hands may be useful as a valid and reliable diagnostic test for predicting a successful LIC block.

U2 - 10.1007/s12630-017-0954-5

DO - 10.1007/s12630-017-0954-5

M3 - Tidsskriftartikel

C2 - 28884374

AN - SCOPUS:85029000437

SN - 0832-610X

VL - 64

SP - 1111

EP - 1118

JO - Canadian Journal of Anaesthesia

JF - Canadian Journal of Anaesthesia

IS - 11

ER -