NDLI: Blinded observer evaluation of distal skin temperature for predicting lateral infraclavicular block success.

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Blinded observer evaluation of distal skin temperature for predicting lateral infraclavicular block success.

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Blinded observer evaluation of distal skin temperature for predicting lateral infraclavicular block success.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Asghar, Semera Lange, Kai H. W. Lundstrøm, Lars H.
Description	Country affiliation: Denmark Author Affiliation: Asghar S ( From the Department of Anaesthesiology and Intensive Care, Nordsjællands Hospital, Copenhagen University, Hillerød, Denmark.)
Abstract	BACKGROUND: Changes in digit skin temperature may be used to predict and determine upper limb nerve block success. We investigated whether a temperature difference between the blocked and the nonblocked hands, simply registered by touching the skin of the 5th and 2nd digit was valid and reliable as a diagnostic test for predicting a successful lateral infraclavicular block. METHODS: Blinded observers investigated temperature difference between the blocked and the nonblocked hands of 40 patients. Sensitivity, specificity, and predictive values of a positive and a negative test were estimated for evaluating the validity of a temperature difference for predicting a successful lateral infraclavicular block defined by sensory and motor block of all 4 major nerves (musculocutaneous, radial, ulnar, and median nerves). κ statistics of interobserver agreement were used for evaluating the reliability of the test. RESULTS: As a stand-alone test, a temperature difference between the corresponding 2nd and 5th digits of the blocked and the nonblocked hands predicted a successful block with a sensitivity of 92% (95 % confidence interval (CI), 83%-97%) and with a predictive value of a positive test of 95% (CI, 86%-98%). Fleiss κ for multiple observers was 0.74, (CI, 0.61-0.87) for the 5th digit and 0.87 (CI, 0.73-0.998) for the 2nd digit, respectively. CONCLUSIONS: We found that a qualitative difference in skin temperature between the blocked and nonblocked hands, measured distally on the 2nd and 5th digits, was a valid and reliable diagnostic test for predicting successful lateral infraclavicular block.
File Format	HTM / HTML
ISSN	00032999
Issue Number	1
Volume Number	120
e-ISSN	15267598
Journal	Anesthesia & Analgesia
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2015-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Brachial Plexus Nerve Block Methods Skin Temperature Physiology Adult Aged Aged, 80 And Over Female Fingers Forearm Surgery Hand Humans Male Middle Aged Observer Variation Predictive Value Of Tests Prospective Studies Reproducibility Of Results Young Adult Journal Article Observational Study Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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