387660

The use of peripheral perfusion index as a predictor for patient’s response to deliberate hypotension during functional endoscopic sinus surgery. A prospective observational study

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Last updated: 05 Jan 2025

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Abstract

: Peripheral perfusion index (PPI) reflects changes in the vasomotor tone. The aim of this observational study is to explore the potentials of the PPI as a predictor of the response to nitroglycerin-induced hypotensive anesthesia in patients undergoing functional endoscopic sinus surgery (FESS).
: Forty-seven patients undergoing FESS were included. Deliberate hypotension was achieved using nitroglycerin infusion titrated to a mean arterial blood pressure (MAP) of 60–65 mmHg. PPI was recorded before induction of anesthesia (baseline), at: 1 minute after induction, 1 minute after endotracheal intubation and just before the initiation of nitroglycerin infusion. The correlation between PPI measured at different time points and the time and the dose requirements of nitroglycerin to achieve the target MAP were evaluated.
: There was a significant positive correlation between the baseline PPI and the time to reach target MAP (r = 0.68, p < 0.0001), the infusion rate of nitroglycerin (r = 0.67, p < 0.0001) and the total intraoperative nitroglycerin consumption (r = 0.65, p < 0.0001). The baseline PPI was the only predictor of nitroglycerin requirement with a cut-off value of 2.8 and an area under the curve 0.85 (95%CI 0.71–0.94, P < 0.0001). The expected individualized dose requirements of nitroglycerin could be derived from the regression equation based on the baseline PPI value.
: Baseline PPI is a good predictor for the patients’ response to nitroglycerin-induced hypotensive anesthesia. Lower baseline PPI values are associated with a reduction in the time and the dose of nitroglycerin required to achieve and maintain the target MAP.
: NCT03007355 Registered on 2 January 2017.

DOI

TEJA-2019-0061

Keywords

Hypotensive anesthesia, Pulse Oximeter, peripheral perfusion index, Nitroglycerin

Authors

First Name

Abeer

Last Name

Ahmed

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Affiliation

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Orcid

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First Name

Mohamed

Last Name

Abdulatif

MiddleName

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Affiliation

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Email

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Orcid

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First Name

Sherif

Last Name

Abdullah

MiddleName

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Affiliation

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Email

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Orcid

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First Name

Neamat Abdel

Last Name

Rahman

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Ahmed

Last Name

Mukhtar

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Orcid

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Volume

35

Article Issue

1

Related Issue

51155

Issue Date

2019-10-01

Receive Date

2019-07-13

Publish Date

2019-10-02

Page Start

94

Page End

99

Print ISSN

1110-1849

Online ISSN

1687-1804

Link

https://egja.journals.ekb.eg/article_387660.html

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https://egja.journals.ekb.eg/service?article_code=387660

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387,660

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Journal

Publication Title

Egyptian Journal of Anaesthesia

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https://egja.journals.ekb.eg/

MainTitle

The use of peripheral perfusion index as a predictor for patient’s response to deliberate hypotension during functional endoscopic sinus surgery. A prospective observational study

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Article

Created At

21 Dec 2024