Effect of infraclavicular and interscalen block on oxygenitaon of the forearandomizedrm : Controlled study

Background: In this study, we aimed to research the oxygenation effects of infraclavicular and interscalen blocks on the forearm by comparing the blood flow (BF) values using the USG, Perfusion index (PI) and regional oxygen saturation (rSO2) values using Near infrared spectroscopy (NIRS) monitorization. Methods: 104 patients, aged between 18-65, with ASA Score I-III, undergoing elective or emergency arm, elbow and forearm surgery were included in the study. In addition to American SOciety of Anesthesiologists (ASA) routine monitorization, in order to measure the PI and NIRS values, pulse oxymetre sensor was put at the 2nd finger, and rSO2 to 1/3 proximal and lateral part of the forearm on the side that the procedure will be done. Fort the other parameters doppler USG was used. Brachial artery was viewed from 2 to 4 cm proximal of the antecubital fossa and values were measured. Time average velocity (TAV), brachial artery diameter (BAD), brachial arterial area (BAA), blood flow (BF), PI and tissue oxygen saturation (rSO2) values were recorded before the procedure. After recording the values before the procedure; Group I received USG and neurostimulator guided infraclavicular block, and Group II received interscalen block. Both groups received 10 ml 2% lidocain and 10 ml 0.05% marcaine for local anetshesia. After the block was administered MAP, HR, TAV, BAD, BAA, BF, PI and rSO2 values were measured and recorded at the 10th, 20th, and 30th minutes. Discussion : In both groups, regional hemodynamic parameters were higher at the 10th, 20th and 30th minutes than the first values, and the increase at the values were statistically signficant. When the increase percantage in PI and rSO2 values between the groups were compared; the increase in group I was found to be higher and statistically signifcant. When BF values were compared between the groups, it was found that the increase was higher in Group I, however it was statistically insignificant. When, the patients' 10th, 20th, and 30th minutes PI, rSO2 and BF values were compared between the groups, it is found that PI and BF values were higher in group I (p<0.05), however there is no statistically significant differnce in between the rSO2 values in between the groups. Results: In this study that we aimed to compare the effects of infraclavicular and interscalen block on the oxygenation of the forearm, PI, BF and rSO2 values were measured and all of the paramteres were found higher at the infraclavicular block group. PI and rSO2 values were found to be higher according to the initial values especially in the infraclavicular block group. With this study we reached the conclusion that infraclavicular block is more effective than interscalen block on the oxygenation of the forearm. Key Words: Blood flow volume, Near infrared spectroscopy, perfusion index, tissue oxygen saturation