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

Authors : Reyhan ARSLANTAS, Mustafa Kemal ARSLANTAS, Gulbin TORE ALTUN, Pelin CORMAN DINCER

Pages : 54-60

Doi:10.5472/marumj.711735

View : 17 | Download : 11

Publication Date : 2020-05-31

Article Type : Research Paper

Abstract :Objective: Limited data are available on the use of the perfusion index insert ignore into journalissuearticles values(PI); and the pleth variability index insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(HR);, blood pressure, SpO2 and ventilation parameters were recorded before anaesthesia induction insert ignore into journalissuearticles values(T0);, 5 min after endotracheal intubation insert ignore into journalissuearticles values(T1);, immediately before surgery, after the patient had been in the reverse Trendelenburg position for 5 min insert ignore into journalissuearticles values(T2);, after inflating the abdomen with CO2 in reverse Trendelenburg insert ignore into journalissuearticles values(T3);, after the abdomen had been deflated insert ignore into journalissuearticles values(T4); and 5 min after extubation insert ignore into journalissuearticles values(T5);. Results: General anaesthesia induced an increase in the PI insert ignore into journalissuearticles values(P<.001);, and a decrease in the PVI insert ignore into journalissuearticles values(P=.002);. The PI and PVI values were not affected during T2 or T3. Pneumoperitoneum caused an increase in mean arterial pressure insert ignore into journalissuearticles values(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.
Keywords : Anaesthesia, Morbid obesity, Pleth variability index, Perfusion index, Bariatric surgery