The Efficacy of Perfusion Index as an Indicator for Intravascular Injection of Epinephrine-Containing Epidural Test Dose in Propofol-Anesthetized Adults

Mowafi, Hany A.; Ismail, Salah A.; Shafi, Mohammed; Alghamdi, Abdullah

doi:10.1213/ane.0b013e31818fc35b

Cited by 58 publications

(45 citation statements)

References 20 publications

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“…The reliability of PI to detect vasoconstriction has been demonstrated by Mowafi et al in the study to detect intravascular injection of epinephrine containing epidural test dose. 12 In this study the cut off value of baseline PI for prediction of hypotension following spinal anaesthesia was chosen as 3.5.In the study by Toyoma et al they did regression analysis and ROC curve analysis and concluded that a baseline PI cut off point of 3.5 could be used to identify pregnant women at risk of hypotension following spinal anaesthesia based on the above study. 8 The baseline PI >3.5 and probability of hypotension were significantly correlating in this study.…”

Section: Discussionmentioning

confidence: 99%

Perfusion Index Assessed from a Pulse Oximeter as a Predictor of Hypotension during Spinal Anaesthesia for Caesarean Section

Varghese¹

2018

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Section: Discussionmentioning

confidence: 99%

Perfusion Index Assessed from a Pulse Oximeter as a Predictor of Hypotension during Spinal Anaesthesia for Caesarean Section

Varghese¹

2018

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“…it is an indirect, noninvasive and continuous measure of peripheral perfusion [10]. Previous studies have demonstrated that an increase in PI is an early indicator that general [6][7][8] and epidural anesthesia [11,12] has initiated peripheral vasodilatation.…”

Section: Discussionmentioning

confidence: 99%

“…In patients of both groups, if any discomfort, agitation or unexpected movement occurred, incremental bolus of propofol (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) mg was given.…”

Section: Methodsmentioning

confidence: 99%

“…It was reported that peripheral perfusion improves during inhalational anesthesia, total intravenous anesthesia [6][7][8], or neuroaxial anesthesia [11,12]. The resulting changes in PI could be useful for monitoring changes in peripheral vasodilatation and sympathetic tone in anesthetized patients, which could reflect the level of analgesia and sedation.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Dexmedetomidine as an Adjunct Agent for Sedation during ERCP

Mahmoud¹,

Hasanin²,

Abdel-Razek³

2016

J Anesth Clin Res

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Objectives: To evaluate dexmedetomidine as an adjunct drug to propofol for sedation during ERCP, and its effects on perfusion index (PI) which could be used as an indicator for analgesia level.Methods: 76 patients ASA (I-III) scheduled for ERCP procedure were randomly classified to either dexmedetomidine/propofol group or propofol group. In dexmedetomidine/propofol group, sedation was induced by dexmedetomidine (0.7 µg/kg) and propofol (50 mg) followed by infusion of dexmedetomidine (0.4 µg/kg/h) and propofol (0.5-1 mg/kg/h). In propofol group, sedation was induced by propofol (50 mg) followed by propofol infusion (0.5-1 mg/kg/h). HR, SBP, DBP, RR, SPO2 and PI were continuously monitored and recorded at the time points (T0 to T8). Results:Comparing dexmedetomidine/propofol group versus propofol group; PI values showed significant increase at T2 to T7 (p˂0.001), HR values showed significant decrease at T1 to T8 (p 0.013 at T1 and 0.001 at T2 to T8), SBP values showed significant decrease at T1 to T8 (p=0.002 at T1, 0.001 at T2 to T7 and 0.004 at T8) and DBP values showed significant decrease at T4 to T6 (p value 0.008, 0.002 and 0.003 at T4.T5 and T6). RR and SPO 2 values were comparable in both groups. In dexmedetomidine/propofol group, the propofol dosage was significantly lower (p value 0.001) and the recovery time was significantly higher (p value 0.001) than that of propofol group, while the procedure time was comparable between both groups. Dexmedetomidine/propofol group showed higher incidence of bradycardia than propofol group (p value 0.035) while propofol group showed more cases with tachycardia (p value 0.016) and more cases with airway obstruction (p value 0.026).Conclusion: dexmedetomidine is a useful adjunct drug for sedation during ERCP procedure.

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“…18 Also in propofol-anesthetized adult patients, the PI was found to be a reliable alternative to conventional hemodynamic criteria for detection of an intravascular injection of epidural test dose. 19 Furthermore, PI was shown to be a reliable and simple alternative to conventional hemodynamic criteria for detection of stress response to insertion of i-gel, laryngeal mask airway and endotracheal tube in adult patients. 20 In the neonatal acute care setting, a low PI has been shown to be an objective and accurate measure of acute illness.…”

Section: Discussionmentioning

confidence: 99%

Perfusion Index is Increased in Acute Complex Regional Pain Syndrome Type 1

Tutoğlu¹

2015

Arch Rheumatol

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Objectives:This study aims to investigate whether perfusion index (PI) changes in the affected extremity of complex regional pain syndrome (CRPS) patients compared to other extremities, and define the possible value of this noninvasive method in evaluating CRPS patients' peripheral perfusion. Patients and methods: Twenty-five CRPS type 1 patients (17 males, 8 females; mean age 37.9±15.1 years; range 20 to 53 years) who fulfilled the Budapest criteria and 22 age, sex and body mass index matched healthy controls from the staff of our hospital were enrolled. The patients and controls were laid in supine position with the palms facing upward. A pulse oximeter sensor was first attached to the fourth finger of the hand with CPRS, and then to the fourth finger of the unaffected hand. PI values were recorded at five minutes after the attachment of the probe. The control group underwent the same procedure for both extremities. Results:The PI values were significantly different between healthy and affected hands of the patients (p=0.007). PI values did not show a significant difference between the left and right hands of the subjects in the control group (p>0.05). Conclusion: This study suggests that peripheral PI of the extremities of early stage CRPS type 1 patients may be useful in the diagnosis process.

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The Efficacy of Perfusion Index as an Indicator for Intravascular Injection of Epinephrine-Containing Epidural Test Dose in Propofol-Anesthetized Adults

Abstract: PI is a reliable alternative to conventional hemodynamic criteria for detection of an intravascular injection of epidural test dose in propofol-anesthetized adult patients.

Cited by 58 publications

References 20 publications

Perfusion Index Assessed from a Pulse Oximeter as a Predictor of Hypotension during Spinal Anaesthesia for Caesarean Section

Perfusion Index Assessed from a Pulse Oximeter as a Predictor of Hypotension during Spinal Anaesthesia for Caesarean Section

Effectiveness of Dexmedetomidine as an Adjunct Agent for Sedation during ERCP

Perfusion Index is Increased in Acute Complex Regional Pain Syndrome Type 1

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