Surgery

Biography

Biography: Dr. Ayşe karcı

Abstract

Perfusion index as a predictor of successful neuraxial anesthesiarnAyse KarcirnDokuz Eylul University, Turkeyrnrn Abstractrnrn Background & Aim: Traditionally evaluation of adequacy of the neuraxial anesthesia depends on the loss of response to the sensations of cold and pinprick which requires patient cooperation. Objective assessment of clinical signs of sympathectomy do not appear fast enough to confirm surgical anesthesia. We hypothesized that increases in the pulse oximeter perfusion index (PI) may provide earlier and clearer objective evidence for sympathectomy compared to traditional responsed to sensory stimulation. rnrnMaterials & Methods: After approval was obtained from the Ethics Committee of University of Dokuz Eylül, Medical School, Ä°zmir, patients between 18-65 years of age who were categorized as American Society of Anesthesiology physical status I-III were included. A spinal block using 0.5% bupivacaine was performed with the patient in the sitting position. No external heating device was used. The upper sensory block level was checked 2 min after the spinal injection by assessing the loss of cold sensation from alcohol swabs. Systolic blood pressure (SAP), heart rate and PI were recorded at 2 min intervals in the first 10 min and then at 5 min intervals. Skin temperature was recorded at the same times. The PI value is generated by pulse oximetry placed on the second toe. rnrnResults & Discussion: Compared to basal values, sympathectomy caused a significant decrease in SAP and an increase in PI values following spinal anesthesia. The incresase in skin temperature was significant after the 8th min. The increase in the PI value and sensory block level were parallel in 15 min following spinal anesthesia and both stayed at a plateau afterwards. In one patient in whom the spinal block was not successful, PI did not significantly change compared to baseline. rn