Does a digital regional nerve block improve the accuracy of noninvasive hemoglobin monitoring?
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Blood hemoglobin (Hb) can be continuously monitored utilizing noninvasive spectrophotometric finger sensors (Masimo SpHb). SpHb is not a consistently accurate guide to transfusion decisions when compared with laboratory Co-Oximetry (tHb). We evaluated whether a finger digital nerve block (DNB) would increase perfusion and, thereby, improve the accuracy of SpHb.
Twenty adult patients undergoing spinal surgery received a DNB with lidocaine to the finger used for the monitoring of SpHb. SpHb–tHb differences were determined immediately following the DNB and approximately every hour thereafter. These differences were compared with those in our previously reported patients (N = 20) with no DNB. The SpHb–tHb difference was defined as “very accurate” if <0.5 g/dL and “inaccurate” if >2.0 g/dL. Perfusion index (PI) values at the time of each SpHb–tHb measurement were compared.
There were 57 and 78 data points in this and our previous study, respectively. The presence of a DNB resulted in 37 % of measurements having SpHb values in the “very accurate group” versus 12 % in patients without a DNB. When the PI value was >2.0, only 1 of 57 DNB values was in the “inaccurate” group. The PI values were both higher and less variable in the patients who received a DNB.
A DNB significantly increased the number of “very accurate” SpHb values and decreased the number of “inaccurate” values. We conclude that a DNB may facilitate the use of SpHb as a guide to transfusion decisions, particularly when the PI is >2.0.
- Does a digital regional nerve block improve the accuracy of noninvasive hemoglobin monitoring?
Journal of Anesthesia
Volume 26, Issue 6 , pp 845-850
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- Springer Japan
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- Anesthesia techniques regional
- Measurement techniques
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- Author Affiliations
- 1. Department of Anesthesia and Perioperative Care, University of California, San Francisco, 521 Parnassus Avenue, C317, San Francisco, CA, 94143-0648, USA
- 2. Department of Epidemiology and Biostatistics, University of California, San Francisco, 185 Berry Street, Lobby 5, Suite 5700, San Francisco, CA, 94107-0560, USA
- 3. Department of Anesthesia and Perioperative Care and Medicine, University of California, San Francisco, 513 Parnassus Avenue, S-211, San Francisco, CA, 94143-0410, USA