Perfusion Index and ultrasonography in the evaluation of infraclavicular block.

BACKGROUND: It has been reported that noninvasive, objective tests are needed for determining the success of peripheral nerve blocks because conventional methods necessitate the cooperation of the patient. It is also known that the brachial plexus block causes vasodilatation and an increase in blood flow due to its sympathectomy effect. Our study aimed to determine whether Perfusion Index (PI) and measured regional hemodynamic changes using ultrasound were reliable parameters in evaluating the early success of an infraclavicular block. METHODS: Forty ASA I-III patients who were administered a successful infraclavicular block were included in this study. In addition to the baseline hemodynamic measurements, PI and regional hemodynamic parameters, such as brachial artery diameter (BAD), brachial arterial area (BAA), blood flow (BF), end-diastolic velocity (EDV), Resistance Index (RI), peak systolic velocity (PSV), and time average velocity (TAV) were measured. After completing the block procedure, all values were rerecorded at the 10th, 20th, and 30th minute. Patients with a successful block during the first 10 minutes were assigned to Group A, while patients with a successful block after the 10th minute were assigned to Group B. RESULTS: Statistically significant differences were observed for all regional hemodynamic variables and PI after 10 minutes. When the regional hemodynamic data and PI were compared between the groups, differences were identified for PI, BF, PSV, EDV, and TAV. Within the measured parameters, EDV was the parameter showing the greatest proportional change. CONCLUSIONS: Changes in EDV, especially RI and PI, provide more effective and objective results for the assessment of early regional block success.

The prevalence of mental retardation by gender, age of diagnosis and location in Zonguldak province, Turkey.

OBJECTIVE: To evaluate the prevalence of mental retardation by gender, age of diagnosis, and location in Zonguldak, Turkey. METHODS: The data of 1909 mentally retarded children recorded between 1995 and 2003 was obtained from the Learning Disability Guidance and Research Centre. Age, gender, IQ scores, the age of diagnosis, and living areas of cases were evaluated. RESULTS: The distribution of mental retardation was as follows; 304 cases (15.9%) were profound and severe, 1060 (55.6%) were moderate and mild, and 545 (28.5%) were borderline. The prevalence of mental retardation was 12.1% (male: 15.1%, female: 9.1%). Of the cases, 1327 (69.5%) lived in urban areas. CONCLUSION: Most individuals with severe mental retardation become enrolled in the service system during early childhood, but children with mild mental retardation, especially those with no other neurological impairments, may never enter the system or may not do so until puberty. Most of our cases were diagnosed between the ages of 6 and 10. This proves the importance of school guidance of learning disability and their collaboration with The Learning Disability Guidance and Research Center.