Can Perfusion Index be used as an Objective Tool for Pain Assessment in Labor Analgesia?

Küpeli, İlke; Kulhan, Nur Gözde

doi:10.12669/pjms.345.15157

Cited by 11 publications

(13 citation statements)

References 17 publications

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“…The PI is calculated as the ratio of pulsatile to non-pulsatile signals in arterial blood flow [ 6 , 7 ]. To date, the PI has been used to predict low blood pressure [ 8 ], identify early success indicators of central and peripheral nerve blocks [ 9 , 10 ], assess pain [ 11 , 12 , 13 ], evaluate systemic vascular resistance [ 14 , 15 ], indicate the success of sympathectomy for hyperhidrosis [ 16 ], and identify the incidence of hypotension after spinal anesthesia [ 17 ]. However, few studies have investigated the correlation between the PI and body temperature.…”

Section: Introductionmentioning

confidence: 99%

Correlation between the Perfusion Index and Intraoperative Hypothermia: A Prospective Observational Pilot Study

et al. 2021

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Background and Objectives: We examined the association between the baseline perfusion index (PI) and changes in intraoperative body temperature during general anesthesia. The PI reflects the peripheral perfusion state. The PI may be associated with changes in body temperature during general anesthesia because the degree of redistribution of body heat from the central to the peripheral compartment varies depending on the peripheral perfusion state. Materials and Methods: Thirty-eight patients who underwent brain surgery were enrolled in this study. The baseline PI and body temperature of the patients were measured on entering the operating room. Body temperature was recorded every 15 min after induction of anesthesia using an esophageal temperature probe. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for intraoperative hypothermia. Results: Eighteen patients (47 %) developed hypothermia intraoperatively. The baseline PI was significantly lower among patients in the hypothermia group (1.8 ± 0.7) than among those in the normothermia group (3.0 ± 1.2) (P < 0.001). The baseline PI and body temperature were independently associated with intraoperative hypothermia (PI: odds ratio [OR], 0.270; 95% confidence interval [CI], 0.105 - 0.697; P = 0.007, baseline body temperature: OR, 0.061; 95% CI, 0.005–0.743; P = 0.028). Conclusions: This study showed that low baseline PI was the factor most related to the development of intraoperative hypothermia. Future studies should consider the PI as a predictor of intraoperative hypothermia.

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Section: Introductionmentioning

confidence: 99%

Correlation between the Perfusion Index and Intraoperative Hypothermia: A Prospective Observational Pilot Study

et al. 2021

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“…And they all proved that PI decreased due to painful stimulus. On the other hand, other studies explored the relationship between PI and analgesia whether under general anaesthesia [2,11,14] or epidural analgesia [15] or transforaminal block [16]. And they all proved that PI increased after analgesic administration.…”

Section: Discussionmentioning

confidence: 98%

“…And they all proved that PI increased after analgesic administration. All of these studies explored different types of pain as postoperative surgical pain [2,11,14,15], intensive care procedural pain [13], electric stimulation pain [8,12] and finally, chronic radicular pain [16].…”

Section: Discussionmentioning

confidence: 99%

“…They enrolled 80 female patients postoperatively, with a different age range, who were observed in PACU before and after intravenous morphine analgesic administration. The second study was done by Kupeli & Kulhan [15]. They investigated the relationship between labour pain level and PI in 30 women undergoing spontaneous vaginal delivery under epidural analgesia.…”

Section: Discussionmentioning

confidence: 99%

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Pulse-oximetry Derived Perfusion Index as a Predictor of the Efficacy of Rescue Analgesia After Major Abdominal Surgeries

Saleh¹,

Mostafa²,

Hamdy³

et al. 2020

TOATJ

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Study Objective: The use of an easy to apply reliable tool is essential to assess pain in patients in intensive care units. This study aimed primarily to evaluate perfusion index usefulness as an objective indicator of pain. Methods and Measurements: Data were collected from 40 non-intubated adult patients admitted to the surgical intensive care unit postoperatively. The Masimo pulse co-oximetry perfusion index (PI) probe was attached to the patient. At the time of the first request for analgesia (T1), the Behavioural pain scale non-intubated scoring system (BPS-NI) was recorded with the PI and patients' haemodynamics following which rescue analgesia was given. Thirty minutes thereafter (T2), second measurements for the mentioned parameters were taken. Main Results: There was a statistically significant reduction in the BPS-NI score, blood pressure and heart rate after analgesic administration (P-values, <0.001, 0.039 and 0.001, respectively), together with a significant increase in the PI (P-value, 0.004). This means that the PI increases with adequate relief from pain, as indicated by a decrease in BPS-NI score and haemodynamics, but the correlation was not statistically significant between their changes. Conclusion: There was no statistically significant correlation between the PI and the pain score or other clinical indicators of pain either before or after the administration of analgesic.

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“…[ 11 ] had proved it to be an earlier and more sensitive indicator of epidural-induced sympathectomy compared to MAP. In a study by Kupeli et al .,[ 12 ] where they had used PI as a tool for assessment of pain in labor analgesia, they had concluded that the PI increased with the decrease in pain and this was due to the sympathetic block and resulting increase in blood flow leading to an increase in the perfusion, and hence, the PI. Klodell et al .…”

Section: Discussionmentioning

confidence: 99%

To study the role of perfusion index as a predictor of hypotension during spinal anesthesia in lower segment cesarean section – A prospective observational study

2021

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Background and Aims: Spinal anesthesia has become the choice of neuraxial anesthesia for cesarean delivery. Hypotension, the most common side effect of spinal anesthesia is more in parturients. Perfusion index (PI) is one of the newest methods, used noninvasively for the prediction of hypotension postspinal anesthesia, evaluation of regional block success, and a tool for pain assessment. In our study, we have used PI for predicting the occurrence of hypotension postsubarachnoid block in elective lower segment cesarean section (LSCS). Methods: In this prospective observational study, parturients posted for elective LSCS under spinal anesthesia were included. Spinal anesthesia was performed at L 3 -L 4 interspace using 25G (gauge) Quincke needle, with 1.8 mL of 0.5% hyperbaric bupivacaine plus 20 μg fentanyl. Hypotension was defined as a decrease in systolic blood pressure >25% from the baseline. Statistical Analysis Used: Statistical analysis was performed using the paired sample t -test, Chi-square test, and independent t -test. Results: From our study, we had found that a positive correlation exists between the baseline PI of the patient and the occurrence of hypotension intraoperatively. A cutoff value of 1.75 (with P < 0.001) was found to be significant; above which the occurrence of hypotension was definite. The sensitivity of this cutoff value was 75% and specificity was 71% for this value. Conclusion: Baseline perfusion of >1.75 can predict hypotension postspinal anesthesia in LSCS. The incidence of hypotension was about 93% in parturients whose baseline was above the cutoff value.

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Can Perfusion Index be used as an Objective Tool for Pain Assessment in Labor Analgesia?

Cited by 11 publications

References 17 publications

Correlation between the Perfusion Index and Intraoperative Hypothermia: A Prospective Observational Pilot Study

Correlation between the Perfusion Index and Intraoperative Hypothermia: A Prospective Observational Pilot Study

Pulse-oximetry Derived Perfusion Index as a Predictor of the Efficacy of Rescue Analgesia After Major Abdominal Surgeries

To study the role of perfusion index as a predictor of hypotension during spinal anesthesia in lower segment cesarean section – A prospective observational study

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