To evaluate tissue oxygen, tissue nutrition and blood value measured by measuring instrument without taking blood from the patient to evaluate the quality of nerve block performed in hand and arm surgeries performed in nerve block

Various methods have been studied for objective evaluation of peripheral nerve block. The aim of this study was to investigate whether tissue oxygen saturation (StO2), tissue perfusion index (PI) and non-invasive total hemoglobin (SPHB) are reliable and objective methods for measuring the quality of the nerve block. StO2, PI and SPHBmeasurements will be made within 5 minutes of the first 30 minutes after the block. Measurements change over time after a successful infraclavicular block is obtained. The InSpectraTM tissue spectrometer (Hutchinson technology, Hutchinson, MN, USA) is a novel non-invasive haemodynamic monitor. It utilises near infra-red spectroscopy (NIRS) technology to measure the proportion of oxygenated haemoglobin relative to total haemoglobin level in the tissue Similarly The perfusion index (PI) and noninvasive blood hemoglobin, which are automatically measured by the pulse oximeter and are indicative of peripheral perfusion in the sensor region (finger), have been shown to be useful methods for evaluating the planned blocks in extremity surgery. StO2, PI and SPHB were measured in 100 patients schedule for elective hand surgery under infraclavicular nerve block. Non-invasive StO2-monitoring (InSpectraTM StO 2, Hutchinson Technology Inc., Hutchinson, Minnesota, USA), PI and SpHb (Upgradable rainbow SET™ Technology Platform) will use in patients before ultrasound guided infraclavicular plexus blockade and during the first 25 minute of the blockade in both hands. The StO2 sensor will be place on the thenar muscle of the right hand in a position, which ensured an adequate total haemoglobin index (THI) of more than 5.0 according to the manufacturer recommendation. To measure tissue oxygen saturation near-infrared light (680–800 nm) is emitted into the thenar tissue with a depth of about 15 mm. In the light that is reflected from the tissue, the percentage of oxygenated haemoglobin is calculated by using the different absorption spectra of oxygenated and deoxygenated haemoglobin. The probe to be used to measure the PI and SpHb (Upgradable SET ™ Technology Platform) will be placed on both the nerve block hand of the patient and the nail part of the middle finger of the unblocked hand and measurements will be taken. measurements will be recorded before block, during block and up to 25 minutes after block infraclavicular blocks will perform using a 22-gauge stimulating needle under US guidance (Esaote My Lab 30 US gold machine, Florence, Italy) using in-plane approach. The blocked and non-blocked arms will compare at precisely timed intervals. However, the duration of sensory block, the duration of motor block, side effects and complications Bromage scale for motor block and Pinprick test in the sensory block will be recorded.