|Peripheral perfusion during total intravenous or combined general anaesthesia|
|Fijałkowska A., Nestorowicz A., Kowalczyk M.|
|Medical University in Lublin, Department of Anaesthesiology and Intensive Care, Lublin, Poland|
|Background and Goal of Study: Peripheral perfusion may be compromised during anaesthesia. It was shown that peripheral perfusion index (PI) correlates well with end-tidal concentration of a volatile anaesthetic used [1, 2]. The aim of study was to assess the changes in PI values during propofol- or sevoflurane-maintained anaesthesia.|
Materials and Methods: ASA I-II class women, scheduled for elective laparoscopic surgery were randomly assigned to two groups: A-combined, or B-intravenous anaesthesia. In group A anaesthesia was induced with thiopentone and suxamethonium and maintained with N2O/O2, sevoflurane, fentanyl and cis-atracurium. In group B propofol and remifentanil were applied for induction and maintenance of anaesthesia using the TCI method, together with air/oxygen mixture and suxamethonium followed by cis-atracurium. During anaesthesia PI values were recorded (Radical-7, Massimo) at the following points: 1-before anaesthesia, 2-after opioid administration during induction, 3-after intubation, 4-skin incision, and then (5-9) at 10-min intervals during maintenance,10-at the end of surgery, 11-eyes opening, 12-extubation, 13-before discharge from the theatre. The Mann-Whitney U test was used for statistical analysis.
Results: Group A consisted of 45 and group B - 43 patients. There were no significant differences between the two groups according to demographic data, time of surgery and anaesthesia. In both groups anaesthesia resulted in an increase in PI, with significantly higher values recorded in group B compared to group A. Completion of anaesthesia caused a decrease in PI to the preoperative values (Fig. 1).
Conclusions: Peripheral perfusion improves during general anaesthesia. TCI with propofol results in better tissue blood flow compared to combined anaesthesia with sevoflurane.
1. Hager H, Reddy D, Kurz A: Anesthesiology 2003; 99: A593.
2. Fijałkowska A, Kowalczyk M: Anaesthesiol Intensive Ther 2010; 42:11-18.