Perfusion index as a predictor of hypotension following propofol induction - A prospective observational study
Background and Aims: Hypotension during propofol induction is a common problem. Perfusion index (PI), an indicator of systemic vascular resistance, is said to be predictive of hypotension following subarachnoid block. We hypothesised that PI can predict hypotension following propofol induction and a...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=12;spage=990;epage=995;aulast=Mehandale |
| _version_ | 1828369542092423168 |
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| author | Sripada G Mehandale Preethi Rajasekhar |
| author_facet | Sripada G Mehandale Preethi Rajasekhar |
| author_sort | Sripada G Mehandale |
| collection | DOAJ |
| description | Background and Aims: Hypotension during propofol induction is a common problem. Perfusion index (PI), an indicator of systemic vascular resistance, is said to be predictive of hypotension following subarachnoid block. We hypothesised that PI can predict hypotension following propofol induction and a cut-off value beyond which hypotension is more common can be determined. Methods: Fifty adults belonging to the American Society of Anesthesiologists' physical status I/II undergoing elective surgery under general anaesthesia were enrolled for this prospective, observational study. PI, heart rate, blood pressure (BP) and oxygen saturation were recorded every minute from baseline to 10 min following induction of anaesthesia with a titrated dose of propofol, and after endotracheal intubation. Hypotension was defined as fall in systolic BP (SBP) by >30% of baseline or mean arterial pressure (MAP) to <60 mm Hg. Severe hypotension (MAP of <55 mm Hg) was treated. Results: Within first 5-min after induction, the incidence of hypotension with SBP and MAP criteria was 30% and 42%, respectively, and that of severe hypotension, 22%. Baseline PI <1.05 predicted incidence of hypotension at 5 min with sensitivity 93%, specificity 71%, positive predictive value (PPV) 68% and negative predictive value (NPV) 98%. The area under the ROC curve (AUC) was 0.816, 95% confidence interval (0.699–0.933), P < 0.001 Conclusion: Perfusion index could predict hypotension following propofol induction, especially before endotracheal intubation, and had a very high negative predictive value. |
| first_indexed | 2024-04-14T06:25:39Z |
| format | Article |
| id | doaj.art-f7deacc4a38f40658d7e0f87eee487fb |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-04-14T06:25:39Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-f7deacc4a38f40658d7e0f87eee487fb2022-12-22T02:07:50ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172017-01-01611299099510.4103/ija.IJA_352_17Perfusion index as a predictor of hypotension following propofol induction - A prospective observational studySripada G MehandalePreethi RajasekharBackground and Aims: Hypotension during propofol induction is a common problem. Perfusion index (PI), an indicator of systemic vascular resistance, is said to be predictive of hypotension following subarachnoid block. We hypothesised that PI can predict hypotension following propofol induction and a cut-off value beyond which hypotension is more common can be determined. Methods: Fifty adults belonging to the American Society of Anesthesiologists' physical status I/II undergoing elective surgery under general anaesthesia were enrolled for this prospective, observational study. PI, heart rate, blood pressure (BP) and oxygen saturation were recorded every minute from baseline to 10 min following induction of anaesthesia with a titrated dose of propofol, and after endotracheal intubation. Hypotension was defined as fall in systolic BP (SBP) by >30% of baseline or mean arterial pressure (MAP) to <60 mm Hg. Severe hypotension (MAP of <55 mm Hg) was treated. Results: Within first 5-min after induction, the incidence of hypotension with SBP and MAP criteria was 30% and 42%, respectively, and that of severe hypotension, 22%. Baseline PI <1.05 predicted incidence of hypotension at 5 min with sensitivity 93%, specificity 71%, positive predictive value (PPV) 68% and negative predictive value (NPV) 98%. The area under the ROC curve (AUC) was 0.816, 95% confidence interval (0.699–0.933), P < 0.001 Conclusion: Perfusion index could predict hypotension following propofol induction, especially before endotracheal intubation, and had a very high negative predictive value.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=12;spage=990;epage=995;aulast=MehandaleBlood pressuregeneral anaesthesiahypotensionintravenous anaestheticsperfusion indexplethysmographypropofol |
| spellingShingle | Sripada G Mehandale Preethi Rajasekhar Perfusion index as a predictor of hypotension following propofol induction - A prospective observational study Indian Journal of Anaesthesia Blood pressure general anaesthesia hypotension intravenous anaesthetics perfusion index plethysmography propofol |
| title | Perfusion index as a predictor of hypotension following propofol induction - A prospective observational study |
| title_full | Perfusion index as a predictor of hypotension following propofol induction - A prospective observational study |
| title_fullStr | Perfusion index as a predictor of hypotension following propofol induction - A prospective observational study |
| title_full_unstemmed | Perfusion index as a predictor of hypotension following propofol induction - A prospective observational study |
| title_short | Perfusion index as a predictor of hypotension following propofol induction - A prospective observational study |
| title_sort | perfusion index as a predictor of hypotension following propofol induction a prospective observational study |
| topic | Blood pressure general anaesthesia hypotension intravenous anaesthetics perfusion index plethysmography propofol |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=12;spage=990;epage=995;aulast=Mehandale |
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