Evaluation Of Pleth Variability Index For Prediction Of Hypotension During Induction Of Anesthesia

Objective:To evaluate the ability of pre-anesthesia pleth variability Index(PVI) in the supine and passive head raising (PHR) position at30°to predict hypotension during the induction of anesthesia.Methods:106patients scheduled for elective surgery under general anesthesia with American Society of Anesthesiologists I-II were involved. Pre-anesthesia blood pressure, heart rate, perfusion index, PVI in the supine position and in PHR at30°were recorded. PI, PVI, the minimum arterial blood pressure and minimum heart rate during anesthesia induction were recorded in all subjects.Results:It is found that blood pressure and heart rate significantly decreased after the induction of anesthesia, and the decline ratio of diastolic arterial blood pressure and the mean arterial blood pressure moderately correlated with pre-anesthesia PVI at30°PHR position.with.Pearson.coefficient.of.0.492and0.463, respectively. The decline ratio of systolic arterial blood pressure,diastolic arterial blood pressure and the mean arterial blood pressure moderately correlated with change of pre-anesthesia PVI at30PHR position and in the supine position with Pearson coefficient of0.502,0.561and0.557, respectively. The change of systolic arterial blood pressure, diastolic arterial blood pressure and the mean arterial blood pressure moderately correlated with change of pre-anesthesia PVI at30°PHR position and in the supine position with Pearson coefficient of0.459,0.577and0.523, respectively. The receiver-operating characteristic curve demonstrated that pre-anesthesia PVI in PHR at30°position could predict hypotension during anesthesia induction with a sensitivity of67%and specificity of62%, whereas pre-anesthesia PVI in the supine position and the change of pre-anesthesia PVI in two position were not reliable in predicting hypotension.Conclusions:Pre-anesthesia PVI in PHR at30°position≥16.5%could predict hypotension during anesthesia.induction..with..propofol.with.acceptable accuracy. This.procedure might be helpful.in..the..assessment..of..high-risk.patients.who.are.susceptible.to. develop severe hypotension during anesthesia induction.