Infrared thermography for assessment of thoracic paravertebral block: a prospective observational study.
Infrared thermography for assessment of thoracic paravertebral block: a prospective observational study.
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红外热成像评估胸椎旁阻滞：一项前瞻性观察研究
DOI：
10.1186/s12871-021-01389-4
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发表时间：
2021-06-11
影响因子：
2.2
通讯作者：
Mei W
中科院分区：
文献类型：
--
作者：
Zhang S;Liu Y;Liu X;Liu T;Li P;Mei W
胸椎旁阻滞（TPVB）的成功或失败没有“金标准”。用红外热像仪测量皮肤温度是评估局部阻滞效果的一种可靠方法。本研究旨在探讨利用IT测定的阻塞侧与未阻塞侧皮肤温差（Td）预测TPVB扩散的可行性。61名接受选择性单侧乳房或胸腔镜手术的患者被纳入这项前瞻性观察研究。在实时超声引导下于T4和T5行TPVB，每位患者应用0.4%罗哌卡因10 mL。在TPVB前及TPVB后5分钟、10分钟、15分钟、20分钟，用IT测量胸壁前T2至T10侧阻塞侧与未阻塞侧之间的Td。穿刺试验于TPVB后20 min进行。成功的TPVB定义为在TPVB后20分钟内，注射部位对应的3个或更多相邻皮节没有针刺感觉。将Td与针刺试验进行比较，以评估其预测TPVB成功的有效性。通过受试者操作特征（receiver operator characteristic， ROC）曲线分析确定Td预测TPVB成功的敏感性、特异性和临界值。与阻断前的基线值相比，成功阻断后T2至T10各时间点的Td均显著升高。在失败的阻断组中，Td在任何皮肤组织中均未增加。tvb成功后20分钟，T4-T7的Td升高超过1℃。阻断后15分钟，T4时Td的增加对阻断成功的预测潜力最大。ROC曲线下面积为0.960，截止值为0.63°C，灵敏度为83.3%，特异性为100.0%。本研究表明，T4皮段Td的升高是早期、定量和可靠的TPVB成功的预测指标，该指标由阻塞侧和未阻塞侧之间的IT测定。临床试验注册：NCT04078347。在线版本包含补充材料，可在10.1186/s12871-021-01389-4获得。
There was no “gold standard” to assess the success or failure of thoracic paravertebral block (TPVB). Measurement of skin temperature with infrared thermography (IT) would be a reliable method to evaluate the effectiveness of regional blocks. This study aimed to explore the feasibility of using skin temperature difference (Td) determined by IT between the blocked and unblocked side to predict the spread of TPVB. Sixty-one patients undergoing elective unilateral breast or thoracoscopic surgery were enrolled in this prospective observational study. TPVB was performed at T4 and T5 under real-time ultrasound guidance with 10 mL of 0.4% ropivacaine for each patient, respectively. Td between the blocked and unblocked side were measured with IT from T2 to T10 at the anterior chest wall before TPVB and 5 min, 10 min, 15 min and 20 min after TPVB. Pinprick test was performed at 20 min after TPVB. Successful TPVB was defined as no sensation to pinprick in 3 or more adjacent dermatomes corresponding to the site of injection at 20 min after TPVB. Td was compared to pinprick test for evaluating its effectiveness in predicting the success of TPVB. The sensitivity, specificity, and cut-off value of Td for predicting successful TPVB were determined by receiver operator characteristic (ROC) curve analysis. Compared with the baseline value before block, Td from T2 to T10 were significantly increased at each time point in successful blocks. In failed blocks, Td was not increased in any dermatome. The increase of Td at T4-T7 was more than 1 °C 20 min after successful TPVB. Fifteen minutes after block, Td increase at T4 had the greatest potential to predict block success. The area under the ROC curve was 0.960 at a cut-off value of 0.63 °C with a sensitivity of 83.3% and a specificity of 100.0%. This study suggested that the increase of Td at T4 dermatome determined by IT between the blocked and unblocked side is an early, quantitative, and reliable predictor of successful TPVB. Clinical trial registration: NCT04078347. The online version contains supplementary material available at 10.1186/s12871-021-01389-4.
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影响因子：
5.1
作者：
Chen H;Liao Z;Fang Y;Niu B;Chen A;Cao F;Mei W;Tian Y
通讯作者：
Tian Y
影响因子：
9.8
作者：
Julien-Marsollier, F.;Rachdi, K.;Dahmani, S.
通讯作者：
Dahmani, S.
影响因子：
2.2
作者：
Dundar, Nurseda;Kus, Alparslan;Solak, Mine
通讯作者：
Solak, Mine
影响因子：
10.7
作者：
Cheema, S;Richardson, J;McGurgan, P
通讯作者：
McGurgan, P
影响因子：
8.8
作者：
Sabourdin, Nada;Barrois, Jerome;Constant, Isabelle
通讯作者：
Constant, Isabelle