3 years ago

“Eyeball test” of thermographic patterns for predicting a successful lateral infraclavicular block

Christian Rothe, Karen E. Linnet, Asger M. Andreasen, Semera Asghar, Lars H. Lundstrøm, Kai H. W. Lange, Charlotte V. Rosenstock

Abstract

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.

Publisher URL: https://link.springer.com/article/10.1007/s12630-017-0954-5

DOI: 10.1007/s12630-017-0954-5

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