CLINICAL TRIAL article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1562770
Clinical Evaluation of the Peripheral Perfusion Index as a Predictor of Femoral Nerve Block Efficacy in Unilateral Arthroscopic Meniscal Surgery
Provisionally accepted
- Affiliated Sport Hospital of CDSU, Chengdu, China
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Objective: To investigate the potential of Perfusion index (PI) as a reliable indicator for assessing the efficacy of femoral nerve block(FNB).Method: A total of 78 patients with knee meniscus injuries, admitted to Affiliated Sport Hospital of CDSU between June 2023 to March 2024, were recruited for this study. All patients had an American society of anesthesiologists (ASA) physical status classification of I or II and were scheduled to undergo unilateral arthroscopic meniscus surgery under general anesthesia supplemented with FNB. Patients who met the inclusion criteria were administered an ultrasound-guided FNB using 20 ml of 0.25% ropivacaine. Following the completion of the nerve block, the PI values of the big toe were monitored on both the blocked and non-blocked sides at two-minute intervals for a total duration of 20 minutes. Concurrently, the sensory and motor functions of the blocked limb were assessed at corresponding time points.The area under the ROC curve (AUROC) of the PI value at T6 on the blocked side was 0.993 (95% CI: 0.982-1.000), with 96.7% sensitivity, 93.3% specificity, a Youden index of 0.934, and a cut-off value of 1.755. PI values differed significantly between the blocked and non-blocked sides at all time points (P<0.001). On the blocked side, PI values varied significantly across time points (P<0.001), with the highest increase at T6 (mean=2.83±0.72, 2.16 times the baseline). No significant changes occurred on the non-blocked side (P>0.05). On the blocked side, male PI values increased more than female values (P<0.001), while no gender differences were observed on the non-blocked side (P>0.05).The PI represents a sensitive and straightforward method that can provide an effective and objective foundation for assessing the success of early FNB. A value above 1.755 indicates successful block, while little change suggests failure.This enables anesthesiologists to promptly adjust anesthetic protocols, enhance the efficiency of knee arthroscopic procedures, and align with the principles of Enhanced recovery after surgery (ERAS).
Keywords: Femoral nerve block, regional anesthesia, Peripheral perfusion index, Meniscal injury, knee arthroscopy, ultrasound
Received: 18 Jan 2025; Accepted: 03 Sep 2025.
Copyright: © 2025 Gong, Zhang, He, Wei and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: li Zhang, Affiliated Sport Hospital of CDSU, Chengdu, China
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