Distal infrared thermography and skin temperature after ultrasound-guided interscalene brachial plexus block: A prospective observational study

Semera Asghar; Lars S Bjerregaard; Lars H Lundstrøm; Jørgen Lund; Morten T Jenstrup; Kai H W Lange

doi:10.1097/EJA.0000000000000152

Distal infrared thermography and skin temperature after ultrasound-guided interscalene brachial plexus block: A prospective observational study

Semera Asghar, Lars S Bjerregaard, Lars H Lundstrøm, Jørgen Lund, Morten T Jenstrup, Kai H W Lange

Anaesthesiology, Department of

12 Citations (Scopus)

Abstract

BACKGROUND: Increases in skin temperature may be used as an early predictor of the success of interscalene brachial plexus block (IBPB), but we lack detailed information on the thermographic response.

OBJECTIVE: To investigate and characterise the thermographic response after IBPBs.

DESIGN: Prospective observational study.

SETTING: University hospital and private hospital.

PATIENTS: Twenty-nine male and 17 female patients scheduled for ambulatory shoulder surgery. Exclusion criteria were age less than 18 years, body weight more than 120 kg and any coagulation abnormality.

INTERVENTIONS: Infrared thermographic imaging of the hand before and at 1 min intervals for 30 min after an ultrasound-guided IBPB with 20 ml ropivacaine 7.5 mg ml. Cooling of both hands was performed to standardise measurements.

MAIN OUTCOME MEASURES: Thermographic changes in skin temperature on the dorsum of the hand.

RESULTS: Forty-four blocks were successful and two were failures. Four thermographic patterns were observed after successful blocks: the increase in skin temperature was restricted to the thumb (n = 5); increase in skin temperature of the thumb and the second digit (n = 11); increase in skin temperature of the thumb, the second and fifth digits (n = 4); and an increase in skin temperature in all parts of the hand (n = 24). All successful blocks demonstrated a significant (P < 0.0001) increase in median (range) of distal skin temperature of the thumb of 6.6°C (0.7 to 17.2) by 30 min, which was already significant (P < 0.0001) by 5 min. By contrast, skin temperature decreased significantly (P < 0.0001) in the hand after failed blocks and in the contra-lateral non-blocked hand by -1.5°C (-6.2 to 4.2).

CONCLUSION: Successful IBPB resulted in four thermographic patterns. Skin temperature always increased on the thumb within 30 min and this increase achieved statistical significance at 5 min after the block.

Original language	English
Journal	European Journal of Anaesthesiology
Volume	31
Issue number	11
Pages (from-to)	626-34
Number of pages	9
ISSN	0265-0215
DOIs	https://doi.org/10.1097/EJA.0000000000000152
Publication status	Published - Nov 2014

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Distal infrared thermography and skin temperature after ultrasound-guided interscalene brachial plexus block: A prospective observational study. / Asghar, Semera; Bjerregaard, Lars S; Lundstrøm, Lars H et al.
In: European Journal of Anaesthesiology, Vol. 31, No. 11, 11.2014, p. 626-34.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Distal infrared thermography and skin temperature after ultrasound-guided interscalene brachial plexus block: A prospective observational study",

abstract = "BACKGROUND: Increases in skin temperature may be used as an early predictor of the success of interscalene brachial plexus block (IBPB), but we lack detailed information on the thermographic response.OBJECTIVE: To investigate and characterise the thermographic response after IBPBs.DESIGN: Prospective observational study.SETTING: University hospital and private hospital.PATIENTS: Twenty-nine male and 17 female patients scheduled for ambulatory shoulder surgery. Exclusion criteria were age less than 18 years, body weight more than 120 kg and any coagulation abnormality.INTERVENTIONS: Infrared thermographic imaging of the hand before and at 1 min intervals for 30 min after an ultrasound-guided IBPB with 20 ml ropivacaine 7.5 mg ml. Cooling of both hands was performed to standardise measurements.MAIN OUTCOME MEASURES: Thermographic changes in skin temperature on the dorsum of the hand.RESULTS: Forty-four blocks were successful and two were failures. Four thermographic patterns were observed after successful blocks: the increase in skin temperature was restricted to the thumb (n = 5); increase in skin temperature of the thumb and the second digit (n = 11); increase in skin temperature of the thumb, the second and fifth digits (n = 4); and an increase in skin temperature in all parts of the hand (n = 24). All successful blocks demonstrated a significant (P < 0.0001) increase in median (range) of distal skin temperature of the thumb of 6.6°C (0.7 to 17.2) by 30 min, which was already significant (P < 0.0001) by 5 min. By contrast, skin temperature decreased significantly (P < 0.0001) in the hand after failed blocks and in the contra-lateral non-blocked hand by -1.5°C (-6.2 to 4.2).CONCLUSION: Successful IBPB resulted in four thermographic patterns. Skin temperature always increased on the thumb within 30 min and this increase achieved statistical significance at 5 min after the block.",

author = "Semera Asghar and Bjerregaard, {Lars S} and Lundstr{\o}m, {Lars H} and J{\o}rgen Lund and Jenstrup, {Morten T} and Lange, {Kai H W}",

year = "2014",

month = nov,

doi = "10.1097/EJA.0000000000000152",

language = "English",

volume = "31",

pages = "626--34",

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T1 - Distal infrared thermography and skin temperature after ultrasound-guided interscalene brachial plexus block

T2 - A prospective observational study

AU - Asghar, Semera

AU - Bjerregaard, Lars S

AU - Lundstrøm, Lars H

AU - Lund, Jørgen

AU - Jenstrup, Morten T

AU - Lange, Kai H W

PY - 2014/11

Y1 - 2014/11

N2 - BACKGROUND: Increases in skin temperature may be used as an early predictor of the success of interscalene brachial plexus block (IBPB), but we lack detailed information on the thermographic response.OBJECTIVE: To investigate and characterise the thermographic response after IBPBs.DESIGN: Prospective observational study.SETTING: University hospital and private hospital.PATIENTS: Twenty-nine male and 17 female patients scheduled for ambulatory shoulder surgery. Exclusion criteria were age less than 18 years, body weight more than 120 kg and any coagulation abnormality.INTERVENTIONS: Infrared thermographic imaging of the hand before and at 1 min intervals for 30 min after an ultrasound-guided IBPB with 20 ml ropivacaine 7.5 mg ml. Cooling of both hands was performed to standardise measurements.MAIN OUTCOME MEASURES: Thermographic changes in skin temperature on the dorsum of the hand.RESULTS: Forty-four blocks were successful and two were failures. Four thermographic patterns were observed after successful blocks: the increase in skin temperature was restricted to the thumb (n = 5); increase in skin temperature of the thumb and the second digit (n = 11); increase in skin temperature of the thumb, the second and fifth digits (n = 4); and an increase in skin temperature in all parts of the hand (n = 24). All successful blocks demonstrated a significant (P < 0.0001) increase in median (range) of distal skin temperature of the thumb of 6.6°C (0.7 to 17.2) by 30 min, which was already significant (P < 0.0001) by 5 min. By contrast, skin temperature decreased significantly (P < 0.0001) in the hand after failed blocks and in the contra-lateral non-blocked hand by -1.5°C (-6.2 to 4.2).CONCLUSION: Successful IBPB resulted in four thermographic patterns. Skin temperature always increased on the thumb within 30 min and this increase achieved statistical significance at 5 min after the block.

AB - BACKGROUND: Increases in skin temperature may be used as an early predictor of the success of interscalene brachial plexus block (IBPB), but we lack detailed information on the thermographic response.OBJECTIVE: To investigate and characterise the thermographic response after IBPBs.DESIGN: Prospective observational study.SETTING: University hospital and private hospital.PATIENTS: Twenty-nine male and 17 female patients scheduled for ambulatory shoulder surgery. Exclusion criteria were age less than 18 years, body weight more than 120 kg and any coagulation abnormality.INTERVENTIONS: Infrared thermographic imaging of the hand before and at 1 min intervals for 30 min after an ultrasound-guided IBPB with 20 ml ropivacaine 7.5 mg ml. Cooling of both hands was performed to standardise measurements.MAIN OUTCOME MEASURES: Thermographic changes in skin temperature on the dorsum of the hand.RESULTS: Forty-four blocks were successful and two were failures. Four thermographic patterns were observed after successful blocks: the increase in skin temperature was restricted to the thumb (n = 5); increase in skin temperature of the thumb and the second digit (n = 11); increase in skin temperature of the thumb, the second and fifth digits (n = 4); and an increase in skin temperature in all parts of the hand (n = 24). All successful blocks demonstrated a significant (P < 0.0001) increase in median (range) of distal skin temperature of the thumb of 6.6°C (0.7 to 17.2) by 30 min, which was already significant (P < 0.0001) by 5 min. By contrast, skin temperature decreased significantly (P < 0.0001) in the hand after failed blocks and in the contra-lateral non-blocked hand by -1.5°C (-6.2 to 4.2).CONCLUSION: Successful IBPB resulted in four thermographic patterns. Skin temperature always increased on the thumb within 30 min and this increase achieved statistical significance at 5 min after the block.

U2 - 10.1097/EJA.0000000000000152

DO - 10.1097/EJA.0000000000000152

M3 - Journal article

C2 - 25232864

SN - 0265-0215

VL - 31

SP - 626

EP - 634

JO - European Journal of Anaesthesiology

JF - European Journal of Anaesthesiology

IS - 11

ER -

Distal infrared thermography and skin temperature after ultrasound-guided interscalene brachial plexus block: A prospective observational study

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