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

Year 2020, Volume: 33 Issue: 2, 54 - 60, 31.05.2020

Reyhan Arslantas Mustafa Kemal Arslantas Gulbin Tore Altun Pelin Corman Dıncer

https://doi.org/10.5472/marumj.711735

Abstract

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

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