title: Change in pulse transit time in the lower extremity after lumbar sympathetic ganglion block: an early indicator of successful block.
abstract: Objective To investigate the change in pulse transit time (PTT)-time between the electrocardiographic R wave and the highest point of the corresponding plethysmographic wave-after lumbar sympathetic ganglion block (LSGB) and evaluate PTT as an indicator of successful LSGB. Methods Sixteen cases of sympathetically mediated lower extremity neuropathic pain treated with LSGB were studied. Correlations between the changes in PTT and temperature were used to identify the cutoff point indicating successful LSGB. Results PTT rate of change at 5 min relative to the baseline PTT (dPTT5/PTT0) significantly correlated positively with the temperature change at 20 min (correlation coefficient 0.734). The dPTT5/PTT0 ratios of the Success and Failure groups were 6.46 ± 2.81% and 2.77 ± 1.72%, respectively. The dPTT5/PTT0 cutoff indicating successful LSGB, based on receiver operating characteristic curve analysis, was 4.23%. Conclusion PTT measurement 5 min after local anesthetic injection was an early, objective indicator of successful or failed LSGB.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Eun-Young
authors.initials: EY
authors.lastname: Joo
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Yu Gyeong
authors.initials: YG
authors.lastname: Kong
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Jonghyuk
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun-Seok
authors.initials: HS
authors.lastname: Cho
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong Hun
authors.initials: JH
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local; D001340:Autonomic Nerve Block; D004562:Electrocardiography; D005260:Female; D005728:Ganglia, Sympathetic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D035002:Lower Extremity / Q000000981:diagnostic imaging / Q000294:innervation / Q000503:physiopathology; D008161:Lumbosacral Region / Q000294:innervation; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D010092:Oximetry; D010991:Plethysmography; D063177:Pulse Wave Analysis / Q000295:instrumentation / Q000379:methods*; D012372:ROC Curve; D012189:Retrospective Studies; D013696:Temperature; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local
keywords: Pulse transit time; blood flow; diagnostic technique; lumbar sympathetic ganglion block; pulse oxymetry; sympathetic nerve block