Ultrasound-guided lateral infraclavicular block evaluated by infrared thermography and distal skin temperature

Semera Asghar; Lars Hyldborg Lundstrøm; Lars Stryhn Bjerregaard; Kai Lange

doi:10.1111/aas.12351

Ultrasound-guided lateral infraclavicular block evaluated by infrared thermography and distal skin temperature

Semera Asghar, Lars Hyldborg Lundstrøm, Lars Stryhn Bjerregaard, Kai Lange

Department of Clinical Medicine

14 Citations (Scopus)

Abstract

BACKGROUND: Brachial plexus blocks cause changes in hand and digit skin temperature. We investigated thermographic patterns after the lateral infraclavicular brachial plexus block. We hypothesised that a successful lateral infraclavicular block could be predicted by increased skin temperature of the 2nd and 5th digits.

METHODS: We performed an ultrasound-guided lateral infraclavicular block in 45 patients undergoing upper limb surgery. The contralateral hand served as control and we obtained infrared thermographic images of both hands before the block and during the following 30 min. We defined areas of interest on the hands and analysed mean skin temperature of each area.

RESULTS: Forty patients completed the study. Thirty blocks were successful, six were failures and four were partial failures. Four distinct patterns of skin temperature changes were revealed with highly significant changes in temperature, depending on block success. A simultaneous 1 °C ipsilateral increase in skin temperature of the 2nd and 5th digits predicted a successful block with a positive predictive value of 100%. A 5 °C difference in digit skin temperature compared with the contralateral hand had a positive predictive value of 96%, and a digit skin temperature ≤ 30 °C 30 min after performing the block had a predictive value of 100% for a failed block.

CONCLUSIONS: Four different thermographic patterns were found. Simultaneous increases in skin temperature of both the 2nd and 5th digits predicted lateral infraclavicular block success with a positive predictive value of 100%. Digit skin temperature ≤ 30 °C 30 min after performing the block indicated block failure.

Original language	English
Journal	Acta Anaesthesiologica Scandinavica
Volume	58
Issue number	7
Pages (from-to)	867-874
Number of pages	8
ISSN	0001-5172
DOIs	https://doi.org/10.1111/aas.12351
Publication status	Published - Aug 2014

Keywords

Adult
Aged
Aged, 80 and over
Brachial Plexus Block
Female
Forearm
Hand
Humans
Infrared Rays
Male
Middle Aged
Predictive Value of Tests
Skin Temperature
Thermography
Ultrasonography, Interventional
Young Adult

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10.1111/aas.12351

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/aas.12351

Cite this

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title = "Ultrasound-guided lateral infraclavicular block evaluated by infrared thermography and distal skin temperature",

abstract = "BACKGROUND: Brachial plexus blocks cause changes in hand and digit skin temperature. We investigated thermographic patterns after the lateral infraclavicular brachial plexus block. We hypothesised that a successful lateral infraclavicular block could be predicted by increased skin temperature of the 2nd and 5th digits.METHODS: We performed an ultrasound-guided lateral infraclavicular block in 45 patients undergoing upper limb surgery. The contralateral hand served as control and we obtained infrared thermographic images of both hands before the block and during the following 30 min. We defined areas of interest on the hands and analysed mean skin temperature of each area.RESULTS: Forty patients completed the study. Thirty blocks were successful, six were failures and four were partial failures. Four distinct patterns of skin temperature changes were revealed with highly significant changes in temperature, depending on block success. A simultaneous 1 °C ipsilateral increase in skin temperature of the 2nd and 5th digits predicted a successful block with a positive predictive value of 100%. A 5 °C difference in digit skin temperature compared with the contralateral hand had a positive predictive value of 96%, and a digit skin temperature ≤ 30 °C 30 min after performing the block had a predictive value of 100% for a failed block.CONCLUSIONS: Four different thermographic patterns were found. Simultaneous increases in skin temperature of both the 2nd and 5th digits predicted lateral infraclavicular block success with a positive predictive value of 100%. Digit skin temperature ≤ 30 °C 30 min after performing the block indicated block failure.",

keywords = "Adult, Aged, Aged, 80 and over, Brachial Plexus Block, Female, Forearm, Hand, Humans, Infrared Rays, Male, Middle Aged, Predictive Value of Tests, Skin Temperature, Thermography, Ultrasonography, Interventional, Young Adult",

author = "Semera Asghar and Lundstr{\o}m, {Lars Hyldborg} and Bjerregaard, {Lars Stryhn} and Kai Lange",

note = "{\textcopyright} 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",

year = "2014",

month = aug,

doi = "10.1111/aas.12351",

language = "English",

volume = "58",

pages = "867--874",

journal = "Acta Anaesthesiologica Scandinavica",

issn = "0001-5172",

publisher = "Wiley-Blackwell",

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TY - JOUR

T1 - Ultrasound-guided lateral infraclavicular block evaluated by infrared thermography and distal skin temperature

AU - Asghar, Semera

AU - Lundstrøm, Lars Hyldborg

AU - Bjerregaard, Lars Stryhn

AU - Lange, Kai

PY - 2014/8

Y1 - 2014/8

N2 - BACKGROUND: Brachial plexus blocks cause changes in hand and digit skin temperature. We investigated thermographic patterns after the lateral infraclavicular brachial plexus block. We hypothesised that a successful lateral infraclavicular block could be predicted by increased skin temperature of the 2nd and 5th digits.METHODS: We performed an ultrasound-guided lateral infraclavicular block in 45 patients undergoing upper limb surgery. The contralateral hand served as control and we obtained infrared thermographic images of both hands before the block and during the following 30 min. We defined areas of interest on the hands and analysed mean skin temperature of each area.RESULTS: Forty patients completed the study. Thirty blocks were successful, six were failures and four were partial failures. Four distinct patterns of skin temperature changes were revealed with highly significant changes in temperature, depending on block success. A simultaneous 1 °C ipsilateral increase in skin temperature of the 2nd and 5th digits predicted a successful block with a positive predictive value of 100%. A 5 °C difference in digit skin temperature compared with the contralateral hand had a positive predictive value of 96%, and a digit skin temperature ≤ 30 °C 30 min after performing the block had a predictive value of 100% for a failed block.CONCLUSIONS: Four different thermographic patterns were found. Simultaneous increases in skin temperature of both the 2nd and 5th digits predicted lateral infraclavicular block success with a positive predictive value of 100%. Digit skin temperature ≤ 30 °C 30 min after performing the block indicated block failure.

AB - BACKGROUND: Brachial plexus blocks cause changes in hand and digit skin temperature. We investigated thermographic patterns after the lateral infraclavicular brachial plexus block. We hypothesised that a successful lateral infraclavicular block could be predicted by increased skin temperature of the 2nd and 5th digits.METHODS: We performed an ultrasound-guided lateral infraclavicular block in 45 patients undergoing upper limb surgery. The contralateral hand served as control and we obtained infrared thermographic images of both hands before the block and during the following 30 min. We defined areas of interest on the hands and analysed mean skin temperature of each area.RESULTS: Forty patients completed the study. Thirty blocks were successful, six were failures and four were partial failures. Four distinct patterns of skin temperature changes were revealed with highly significant changes in temperature, depending on block success. A simultaneous 1 °C ipsilateral increase in skin temperature of the 2nd and 5th digits predicted a successful block with a positive predictive value of 100%. A 5 °C difference in digit skin temperature compared with the contralateral hand had a positive predictive value of 96%, and a digit skin temperature ≤ 30 °C 30 min after performing the block had a predictive value of 100% for a failed block.CONCLUSIONS: Four different thermographic patterns were found. Simultaneous increases in skin temperature of both the 2nd and 5th digits predicted lateral infraclavicular block success with a positive predictive value of 100%. Digit skin temperature ≤ 30 °C 30 min after performing the block indicated block failure.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Brachial Plexus Block

KW - Female

KW - Forearm

KW - Hand

KW - Humans

KW - Infrared Rays

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Skin Temperature

KW - Thermography

KW - Ultrasonography, Interventional

KW - Young Adult

U2 - 10.1111/aas.12351

DO - 10.1111/aas.12351

M3 - Journal article

C2 - 24924688

SN - 0001-5172

VL - 58

SP - 867

EP - 874

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

IS - 7

ER -

Ultrasound-guided lateral infraclavicular block evaluated by infrared thermography and distal skin temperature

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