Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia?

Wajima, Zen’ichiro; Shiga, Toshiya; Imanaga, Kazuyuki

doi:10.5582/bst.2017.01253

Cited by 5 publications

(9 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, the anaesthesia methods (general anaesthesia or combined epidural), anaesthetic drugs (midazolam, propofol, rocuronium or cisatracurium) and opioids (remifentanil or fentanyl) used differed among studies, as did the patient characteristics (height and weight), mechanical ventilation strategies (tidal volume or PEEP). In our study, the PVI did not change after the pneumoperitoneum, similar to the results of Wajima et al They suggested that the most likely mechanism underlying this outcome was that remifentanil and epidural analgesia block noxious stimuli and sympathetic activity in the fingertips [10]. We only administered remifentanil as an opioid to our patients; epidural anaesthesia was not used, which blocks sympathetic activity and vasoconstriction resulting from pneumoperitoneum or surgery.…”

Section: Discussionsupporting

confidence: 90%

“…Furthermore, the SVV increases, according to Liu et al [23], although Høiseth et al found that SVV was unchanged after pneumoperitoneum [22]. Wajima et al [10] reported that pneumoperitoneum did not change the PVI, but decreased the PI and increased the SVV. These discrepancies regarding the effects of pneumoperitoneum may be related to differences in study design.…”

Section: Discussionmentioning

confidence: 99%

“…Dynamic parameters, such as the PVI and stroke volume variation (SVV), may also be affected by changes in intra-abdominal pressure. Several animal and clinical studies have investigated the effects of pneumoperitoneum and/ or intra-abdominal pressure on dynamic parameters [10,[20][21][22][23]. These experimental studies showed that the PPV and SVV were affected by increased intra-abdominal pressure, but neither the PPV nor SVV predicted fluid responsiveness [20].…”

Section: Discussionmentioning

confidence: 99%

“…Optimising tissue and organ perfusion through goal-directed fluid therapy based on dynamic predictors of fluid responsiveness improves clinical outcomes [6,7]. However, there are limitations and drawbacks to the PI and PVI that restrict their use depending on the patient's position, pneumoperitoneum and use of norepinephrine, for example [8][9][10][11]. The effects of these variables have mainly been assessed in healthy individuals and non-morbidly obese patients undergoing laparoscopy [10,12].…”

Section: Introductionmentioning

confidence: 99%

“…However, there are limitations and drawbacks to the PI and PVI that restrict their use depending on the patient's position, pneumoperitoneum and use of norepinephrine, for example [8][9][10][11]. The effects of these variables have mainly been assessed in healthy individuals and non-morbidly obese patients undergoing laparoscopy [10,12]. Moreover, few studies have used the PI and PVI to predict fluid responsiveness during laparoscopic bariatric surgery [7].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The effects of pneumoperitoneum and patient position on the perfusion index and pleth variability index during laparoscopic bariatric surgery

Arslantaş

Altun

et al. 2020

Marmara Medical Journal

View full text Add to dashboard Cite

Objective: Limited data are available on the use of the perfusion index (PI) and the pleth variability index (PVI) during laparoscopic bariatric surgery. We investigated the effects of pneumoperitoneum and the reverse Trendelenburg position on these indices. Materials and Methods: PI, PVI, heart rate (HR), blood pressure, SpO 2 and ventilation parameters were recorded before anaesthesia induction (T0), 5 min after endotracheal intubation (T1), immediately before surgery, after the patient had been in the reverse Trendelenburg position for 5 min (T2), after inflating the abdomen with CO 2 in reverse Trendelenburg (T3), after the abdomen had been deflated (T4) and 5 min after extubation (T5). Results: General anaesthesia induced an increase in the PI (P<.001), and a decrease in the PVI (P=.002). The PI and PVI values were not affected during T2 or T3. Pneumoperitoneum caused an increase in mean arterial pressure (MAP) and a decrease in HR. PVI and MAP decreased during T4, but the PI and HR remained unchanged. PVI, HR and MAP increased during T5. Conclusion: Our data suggest that the reverse Trendelenburg position and pneumoperitoneum did not affect the PI or PVI values, whereas deflation decreased the PVI in morbidly obese patients under general anaesthesia.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The effects of pneumoperitoneum and patient position on the perfusion index and pleth variability index during laparoscopic bariatric surgery

Arslantaş

Altun

et al. 2020

Marmara Medical Journal

View full text Add to dashboard Cite

show abstract

Laparoskopi̇k Sleeve Gastrektomi̇ Ameli̇yatlarinda Karin İçi̇ Basinç Artişinin Ortalama Trombosi̇t Hacmi̇ Üzeri̇ne Etki̇si̇ni̇n Araştirilmasi

Kızıldağ,

Doğru,

Kaçmaz

et al. 2024

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

View full text Add to dashboard Cite

Amaç: Obezite, adipoz dokuda, sağlığı bozacak düzeyde anormal ya da aşırı yağ birikimi olarak tanımlanmaktadır. Obezite tedavisinde cerrahi uygulamalar, son yıllarda sıklıkla uygulanmaya başlanmıştır. Ancak bu tür cerrahi uygulamalarda intraoperatif karın içi basınç artışı endişe konusu olabilir. Bu çalışmada laparoskopik sleeve gastrektomi operasyonundaki intraabdominal basınç artışının, trombosit aktivitesinin bir göstergesi olan ortalama trombosit hacmine (MPV) etkilerini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya yaşları 18 ile 65 arasında olan 60 hasta dahil edildi. Tüm hastalara intraabdominal basınç 13-15 mm/Hg aralığında ayarlanarak, elektif laparoskopik sleeve gastrektomi operasyonu yapıldı. Preoperatif, intraoperatif ve postoperatif MPV değerleri ölçülerek bu değerler arasında istatistiksel olarak anlamlı fark olup olmadığı değerlendirildi. Bulgular: Hastaların vücut kitle indeksi ortalamaları 44.46±4.18 idi. Hastaların MPV ortalama değerleri MPV preoperatif 10.03±0.95 fl, MPV intraoperatif 10.17±0.95 fl, MPV postoperatif 10.32±0.81 fl olarak ölçüldü. Preoperatif ve intraoperatif MPV değerleri arasında anlamlı fark oluşmaz iken, preoperatif ve postoperatif, intraoperatif ve postoperatif MPV değerine arasında istatistiksel anlamlı fark oluştuğu gözlendi. Sonuç: İntraabdominal basınç altında yapılan laparoskopik operasyonlarda, trombosit fonksiyonlarına bağlı koagulasyon bozuklukları açısından trombosit büyüklüğünün bir göstergesi olan MPV değerinin izlenmesinin, cerrahi sonrası akut trombotik hadiselerin takibi açısından uygun olacağını düşünmekteyiz.

show abstract

Geriyatrik cerrahi hastalarının intraoperatif sıvı yönetiminde pleth değişkenlik indeksinin potansiyel değeri

Ergün

Zengin

Bilgili

et al. 2022

Archives of Clinical and Experimental Medicine

View full text Add to dashboard Cite

Aim: This study was designed to determine the effects of pleth variability index (PVI) guided monitoring on the optimal intravascular volume replacement during hip and knee arthroplasty in geriatric patients, and whether using PVI could reduce blood transfusion and vasopressor requirements. Methods: One-hundred geriatric patients who underwent elective hip and knee arthroplasty were included, assigned to either PVI group (volume replacement was PVI guided) or to a control group (volume replacement was based on traditional methods). Sealed envelope technique was used for randomization. Perioperative hemodynamic parameters, infusion rate of crystalloids, colloids, blood/blood products, ephedrine hydrochloride requirements and perioperative urine outputs were recorded. Results: Crystalloid infusion rate was higher (9.5 vs. 6.8 ml/kg/h, p<0.001) and ephedrine requirement was lower (2.0% vs. 38.0%, p<0.001) in group PVI. Postoperatively, the percentage of patients with high BUN, creatinine, and lactate levels were higher among controls (p<0.001). PVI group had significantly lower mean heart rate intraoperatively. Conclusions: Our findings suggest that intraoperative fluid replacement guided by PVI monitoring provides hemodynamic stability, preserves normal levels of BUN, creatinine, and lactate, and reduces unnecessary use of vasopressor agents in elderly surgical patients.

show abstract

Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia?

Cited by 5 publications

References 34 publications

The effects of pneumoperitoneum and patient position on the perfusion index and pleth variability index during laparoscopic bariatric surgery

The effects of pneumoperitoneum and patient position on the perfusion index and pleth variability index during laparoscopic bariatric surgery

Laparoskopi̇k Sleeve Gastrektomi̇ Ameli̇yatlarinda Karin İçi̇ Basinç Artişinin Ortalama Trombosi̇t Hacmi̇ Üzeri̇ne Etki̇si̇ni̇n Araştirilmasi

Geriyatrik cerrahi hastalarının intraoperatif sıvı yönetiminde pleth değişkenlik indeksinin potansiyel değeri

Contact Info

Product

Resources

About