Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-59251 | DOI: 10.5152/TJAR.2019.59251  

Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study

İlke Küpeli1, Faruk Subaşı1, Nurhan Eren1, Yusuf Kemal Arslan2
1Department of Anaesthesiology and Reanimation, Erzincan Binali Yıldırım University School of Medicine, Erzincan, Turkey
2Department of Biostatistics and Medical Informatics, Erzincan Binali Yıldırım University School of Medicine, Erzincan, Turkey

Objective: We aimed to test the efficacy of preoperative Pleth variability index in evaluating hypotension developing after spinal anaesthesia in patients who were spontaneously breathing, preoperatively hypovolemic, were at advanced age.
Methods: This is an observational study of 94 patients aged >65 years with hip fracture. Demographic data, preoperative heart rate, non-invasive arterial pressures, Pleth variability index, and haemogram values were continuously measured following spinal anaesthesia. These measurements with and without hypotension were distinguished and their data were compared.
Results: The mean age of the patients was 77.4±8.2 years. In total, 56.4% of patients developed hypotension after spinal anaesthesia, and hypotension was higher in women(p=0.037). Low preoperative diastolic arterial pressures values were associated with the development of hypotension(p=0.037). The relationship between PVI and postspinal hypotension was negative but significant (r=-0.239; p<0.05).Depending on the volume loss, we observed an increase in Pleth variability index(p<0.001) and a significant decrease in Pleth variability index after treatment in patients with hypotension(p<0.001). The correlation between noninvasively measured haemoglobin values and those values obtained from arterial blood gas samples was significant (p<0.001).
Conclusion: This study showed that post-spinal hypotension may be associated with increased as well as decreased Pleth variability index values, but these values cannot be clinically used for predicting preoperative hypotension in hypovolemic patients.
ClinicalTrials.gov ID: NCT02984956

Keywords: Advanced age, hypotension, pleth variability index, spinal anaesthesia




Corresponding Author: İlke Küpeli, Türkiye


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