[Improved detection of the pulse oximeter signal with a digital nerve block in patients in poor health status].
OBJECTIVE
To demonstrate the efficacy of a digital nerve block for improving pulse oximetry in conditions of low tissue perfusion.


METHODS
A randomized single-blind study of adult patients undergoing surgery under general anesthesia for conditions characterized by hypoperfusion. Patients were assigned to a control group or an experimental group. The experimental group received a digital nerve block in the middle finger of the left hand; a sensor was then placed on the finger for between 120 and 300 minutes. Age, sex, diagnosis, total observation time (TOT), percentage of time with no pulse oximeter signal (NoPO), and percentage of time with an unstable pulse oximeter signal (UnstPO) were recorded. Each patient was questioned between 16 and 24 hours after surgery and was examined for flushing, paresthesia, hypoesthesia, pain, and ecchymosis. The chi2 test was used to compare dichotomized or nominal variables and the t test was used to compare age, TOT, NoPO, and UnstPO. Values of P<.05 were considered statistically significant in both cases.


RESULTS
Fifty patients were randomized to each group. A total of 82 patients remained in the study (control group=42, experimental group=40). There were no significant between-group differences in diagnoses or TOT. The mean values for NoPO and UnstPO were higher in the control group than in the experimental group (11.1% vs 4.4% and 35.9% vs 15.7%, respectively; P<.001).


CONCLUSIONS
A digital nerve block can be used to prevent pulse oximetry failures in conditions of low peripheral perfusion.
Cordoví de Armas
L
L
Hospital Clínico Quirúrgico Universitario Hermanos Ameijeiras, La Habana, Cuba.
Espinaco Valdés
J
J
Jiménez Paneque
R E
RE
Costa Hidalgo
T
T
Vallongo Menéndez
M B
MB
D000328:Adult; D000368:Aged; D001340:Autonomic Nerve Block; D004868:Equipment Failure; D005260:Female; D005385:Fingers / Q000098:blood supply* / Q000294:innervation; D006470:Hemorrhage / Q000097:blood; D006801:Humans; D007511:Ischemia / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D010538:Peritonitis / Q000097:blood; D012769:Shock / Q000097:blood; D016037:Single-Blind Method; D014661:Vasoconstriction
D010100:Oxygen