Perfusion index as a predictor of hypotension following induction of general anaesthesia with propofol-An observational study
Background: Perfusion index (PI) is a somewhat novel parameter evaluating the pulsatility of blood in the extremities, calculated using the infrared spectrum as a component of plethysmography waveform processing. Aims and Objectives: To obtain a cutoff value of pre-anesthesia PI, which may be hel...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Manipal College of Medical Sciences, Pokhara
2024-01-01
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| Series: | Asian Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/54012 |
| _version_ | 1827394038569893888 |
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| author | Rithwik K Rajeev Aswathy S Vrinda M Yedudev SB |
| author_facet | Rithwik K Rajeev Aswathy S Vrinda M Yedudev SB |
| author_sort | Rithwik K Rajeev |
| collection | DOAJ |
| description | Background: Perfusion index (PI) is a somewhat novel parameter evaluating the pulsatility of blood in the extremities, calculated using the infrared spectrum as a component of plethysmography waveform processing.
Aims and Objectives: To obtain a cutoff value of pre-anesthesia PI, which may be helpful for the prediction of hypotension following anesthetic induction with propofol.
Materials and Methods: This descriptive observational research was carried out at the Sree Gokulam medical college and research foundation, Venjaramoodu, Trivandrum, Kerala, from June 2020 to June 2021. A total of 174 patients of age group 17–60 years, with ASA 1 or 2 scheduled for surgery under general anesthesia, were included. The parameters (systolic blood pressure [SBP], diastolic blood pressure, mean arterial pressure, PI, and SPO2) were recorded until 5 min of induction. Intravenous (IV) fentanyl 2 μg/kg was administered, propofol injected was given slowly at a rate of 10 mg per every 5 s, titrated to loss of verbal communication responseuronium 0.1 mg/kg IV was administered. The calculation for hypertension was done 5 min after anesthesia. The predictive validity of PI was calculated, keeping SBP as the standard gold test. For statistical analysis coGuide software.
Results: The cutoff value for PI at 5 min was low (≤2.45) for 27 (90%) participants and high (>2.45) for 3 (10%) participants. With a sensitivity of 90% in predicting hypotension and specificity of 87.50%, false-positive rate was 12.50%, false-negative rate was 10, positive predictive value was 60% (95 CI 44.43–74.30%), the negative predictive value (NPV) was 97.67%, and the total diagnostic accuracy was 87.93%.
Conclusion: With the current study’s findings, we conclude that PI cutoff value 2.45 can be used to predict hypotension following anesthetic induction with propofol. It has a high NPV with fair diagnostic accuracy. |
| first_indexed | 2024-03-08T18:01:16Z |
| format | Article |
| id | doaj.art-690a119e6b7e4947ae12f0a4b9f9bb62 |
| institution | Directory Open Access Journal |
| issn | 2467-9100 2091-0576 |
| language | English |
| last_indexed | 2024-03-08T18:01:16Z |
| publishDate | 2024-01-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj.art-690a119e6b7e4947ae12f0a4b9f9bb622024-01-02T01:36:23ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762024-01-011513338https://doi.org/10.3126/ajms.v15i1.54012Perfusion index as a predictor of hypotension following induction of general anaesthesia with propofol-An observational studyRithwik K Rajeev 0https://orcid.org/0009-0001-8119-9159Aswathy S 1https://orcid.org/0009-0005-8210-9441Vrinda M 2https://orcid.org/0009-0003-5295-8851Yedudev SB3https://orcid.org/0009-0000-3557-300XAssistant Professor, Department of Anaesthesiology and Critical Care, Sree Gokulam Medical College and Research Foundation, Trivandrum, Kerala, India Assistant Professor, Department of Anaesthesiology and Critical Care, Sree Gokulam Medical College and Research Foundation, Trivandrum, Kerala, India Senior Resident, Department of Anaesthesiology and Critical Care, Sree Gokulam Medical College and Research Foundation, Trivandrum, Kerala, India Assistant Professor, Department of Anaesthesiology and Critical Care, Sree Gokulam Medical College and Research Foundation, Trivandrum, Kerala, India Background: Perfusion index (PI) is a somewhat novel parameter evaluating the pulsatility of blood in the extremities, calculated using the infrared spectrum as a component of plethysmography waveform processing. Aims and Objectives: To obtain a cutoff value of pre-anesthesia PI, which may be helpful for the prediction of hypotension following anesthetic induction with propofol. Materials and Methods: This descriptive observational research was carried out at the Sree Gokulam medical college and research foundation, Venjaramoodu, Trivandrum, Kerala, from June 2020 to June 2021. A total of 174 patients of age group 17–60 years, with ASA 1 or 2 scheduled for surgery under general anesthesia, were included. The parameters (systolic blood pressure [SBP], diastolic blood pressure, mean arterial pressure, PI, and SPO2) were recorded until 5 min of induction. Intravenous (IV) fentanyl 2 μg/kg was administered, propofol injected was given slowly at a rate of 10 mg per every 5 s, titrated to loss of verbal communication responseuronium 0.1 mg/kg IV was administered. The calculation for hypertension was done 5 min after anesthesia. The predictive validity of PI was calculated, keeping SBP as the standard gold test. For statistical analysis coGuide software. Results: The cutoff value for PI at 5 min was low (≤2.45) for 27 (90%) participants and high (>2.45) for 3 (10%) participants. With a sensitivity of 90% in predicting hypotension and specificity of 87.50%, false-positive rate was 12.50%, false-negative rate was 10, positive predictive value was 60% (95 CI 44.43–74.30%), the negative predictive value (NPV) was 97.67%, and the total diagnostic accuracy was 87.93%. Conclusion: With the current study’s findings, we conclude that PI cutoff value 2.45 can be used to predict hypotension following anesthetic induction with propofol. It has a high NPV with fair diagnostic accuracy.https://www.nepjol.info/index.php/AJMS/article/view/54012perfusion index; propofol; general anesthesia; hypotension; roc curve |
| spellingShingle | Rithwik K Rajeev Aswathy S Vrinda M Yedudev SB Perfusion index as a predictor of hypotension following induction of general anaesthesia with propofol-An observational study Asian Journal of Medical Sciences perfusion index; propofol; general anesthesia; hypotension; roc curve |
| title | Perfusion index as a predictor of hypotension following induction of general anaesthesia with propofol-An observational study |
| title_full | Perfusion index as a predictor of hypotension following induction of general anaesthesia with propofol-An observational study |
| title_fullStr | Perfusion index as a predictor of hypotension following induction of general anaesthesia with propofol-An observational study |
| title_full_unstemmed | Perfusion index as a predictor of hypotension following induction of general anaesthesia with propofol-An observational study |
| title_short | Perfusion index as a predictor of hypotension following induction of general anaesthesia with propofol-An observational study |
| title_sort | perfusion index as a predictor of hypotension following induction of general anaesthesia with propofol an observational study |
| topic | perfusion index; propofol; general anesthesia; hypotension; roc curve |
| url | https://www.nepjol.info/index.php/AJMS/article/view/54012 |
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