Twelve percent of the patients showed a minimal lack of strength in the quadriceps muscle and 11% had residual sensory anesthesia to pinprick below L5/S1.īased on our observations, recovery of vibration sense corresponds with recovery of motor block after epidural anesthesia and may serve as an easy means of documenting recovery with a single test before discharge. Statistical analysis was performed to compare the results of the different methods to the time at which baseline values of vibration sense were reached.Īt the time vibration sense testing returned to baseline, there was no residual motor block according to the Bromage Score in 100% of the patients and no residual block for foot flexion and extension. After obtaining baseline values, an epidural anesthetic was performed and patients were tested every 30 minutes until complete recovery from the block was documented with all examined methods. Vibration Sense use a 128 hertz vibration fork apply the stimulus over the distal phalanx of the index finger or large toe.
Epidural blocks were performed by the same anesthesiologist using ropivacaine and sufentanil via an epidural catheter. Conventional block recovery testing included Bromage-Score, formal muscle power testing according to the British Medical Research Council, pinprick testing, and warm/cold testing.
Recovery from epidural block was evaluated in 81 patients undergoing cesarean delivery or vein stripping by comparing the use of a 128-Hz tuning fork with the results of conventional evaluation of block recovery. In this open, prospective study, we tested the hypothesis that vibration sense testing is a sensitive and specific method to assess recovery from epidural block.
Vibration sense testing using a 128-Hz tuning fork is a commonly used test in the diagnosis of dorsal horn dysfunction and polyneuropathy.
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