Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery

Introduction: Laryngoscopy and intubation is always associated with a short term reflex sympathetic pressor response. The perfusion index is an indirect, non-invasive, and continuous measure of peripheral perfusion by pulse oximeter which can detect the stress response to intubation similar to hear...

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Autores principales:	Sushila Lama Moktan, Manan Karki
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2020
Materias:	Endotraheal intubation Haemodynamic changes Perfusion index Stress response Surgery RD1-811
Acceso en línea:	https://doaj.org/article/84ef2174d41545fc97773ea472d78ceb
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spelling	oai:doaj.org-article:84ef2174d41545fc97773ea472d78ceb2021-12-05T19:15:39ZComparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery10.3126/jssn.v23i2.357971815-39842392-4772https://doaj.org/article/84ef2174d41545fc97773ea472d78ceb2020-12-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/35797https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction: Laryngoscopy and intubation is always associated with a short term reflex sympathetic pressor response. The perfusion index is an indirect, non-invasive, and continuous measure of peripheral perfusion by pulse oximeter which can detect the stress response to intubation similar to heart rate, systolic blood pressure and diastolic blood pressure. Methods: This prospective observational study enrolled sixty-five normotensive patients of American society of anesthesiologists physical status grade I and II scheduled for elective surgery under general anaesthesia. Tracheal intubation was performed after induction with intravenous fentanyl, propofol and vecuronium. Heart rate, Systolic and Diastolic Blood Pressure and Perfusion Index were measured before induction of anesthesia, before intubation and one minute, three minutes, five minutes after the insertion of the endotracheal tube. Increase in heart rate by ?10 beats per minute, systolic and diastolic blood pressure by ?15 millimeters of mercury and decrease in Perfusion index ?10% after endotracheal intubation as compared to preintubation value were considered positive haemodynamic changes. Results: Endotracheal intubation produced a significant increase in heart rate and blood pressure whereas perfusion index decreased significantly. Our study showed that perfusion index response criterion achieved 97.7% (Confidence interval 97.58-97.86) sensitivity in detecting the stress response to insertion of endotracheal tube whereas systolic and diastolic blood pressure achieved sensitivity of 90% and 92% respectively. Conclusion: Perfusion Index is easier, reliable and non-invasive alternative to conventional haemodynamic criteria for detection of stress response to endotracheal intubation. Sushila Lama MoktanManan KarkiSociety of Surgeons of NepalarticleEndotraheal intubationHaemodynamic changesPerfusion indexStress responseSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 23, Iss 2 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Endotraheal intubation Haemodynamic changes Perfusion index Stress response Surgery RD1-811
spellingShingle	Endotraheal intubation Haemodynamic changes Perfusion index Stress response Surgery RD1-811 Sushila Lama Moktan Manan Karki Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery
description	Introduction: Laryngoscopy and intubation is always associated with a short term reflex sympathetic pressor response. The perfusion index is an indirect, non-invasive, and continuous measure of peripheral perfusion by pulse oximeter which can detect the stress response to intubation similar to heart rate, systolic blood pressure and diastolic blood pressure. Methods: This prospective observational study enrolled sixty-five normotensive patients of American society of anesthesiologists physical status grade I and II scheduled for elective surgery under general anaesthesia. Tracheal intubation was performed after induction with intravenous fentanyl, propofol and vecuronium. Heart rate, Systolic and Diastolic Blood Pressure and Perfusion Index were measured before induction of anesthesia, before intubation and one minute, three minutes, five minutes after the insertion of the endotracheal tube. Increase in heart rate by ?10 beats per minute, systolic and diastolic blood pressure by ?15 millimeters of mercury and decrease in Perfusion index ?10% after endotracheal intubation as compared to preintubation value were considered positive haemodynamic changes. Results: Endotracheal intubation produced a significant increase in heart rate and blood pressure whereas perfusion index decreased significantly. Our study showed that perfusion index response criterion achieved 97.7% (Confidence interval 97.58-97.86) sensitivity in detecting the stress response to insertion of endotracheal tube whereas systolic and diastolic blood pressure achieved sensitivity of 90% and 92% respectively. Conclusion: Perfusion Index is easier, reliable and non-invasive alternative to conventional haemodynamic criteria for detection of stress response to endotracheal intubation.
format	article
author	Sushila Lama Moktan Manan Karki
author_facet	Sushila Lama Moktan Manan Karki
author_sort	Sushila Lama Moktan
title	Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery
title_short	Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery
title_full	Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery
title_fullStr	Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery
title_full_unstemmed	Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery
title_sort	comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery
publisher	Society of Surgeons of Nepal
publishDate	2020
url	https://doaj.org/article/84ef2174d41545fc97773ea472d78ceb
work_keys_str_mv	AT sushilalamamoktan comparisonofnoninvasivehaemodynamicmonitorsofstressresponsetoendotrachealintubationwithperfusionindexinpatientsundergoingelectivesurgery AT manankarki comparisonofnoninvasivehaemodynamicmonitorsofstressresponsetoendotrachealintubationwithperfusionindexinpatientsundergoingelectivesurgery
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Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery

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