Sarihan Seda, Koyuncu Tolga, Kazancioglu Leyla, Batcik Sule, Kazdal Hizir
Anesthesiology and Reanimation Clinic, Kaçkar State Hospital, 53300 Rize, Turkey.
Department of Anesthesiology and Reanimation, Faculty of Medicine, Recep Tayyip Erdogan University, 53020 Rize, Turkey.
J Pers Med. 2024 Feb 25;14(3):247. doi: 10.3390/jpm14030247.
The study aimed to assess the pleth variability index (PVI) in patients undergoing lumbar disc herniation surgery under general and spinal anesthesia, exploring its correlation with fluid responsiveness, position, and hemodynamic parameters. Methods: This prospective study included 88 ASA 1-2 patients, aged 18-65, undergoing 1-3 h elective lumbar disc herniation surgery. Patients in groups GA and SA were observed for demographic, operative, and hemodynamic parameters at specified time points. (3) Results: PVI values were comparable between the GA and SA groups. After 250 mL of fluid loading, both groups showed a significant decrease in basal PVI at T2. Prone positions in GA exhibited higher PI values than in SA. The transition from a prone to supine position maintained PVI, while pulse and MAP decreased.; (4) Conclusions: PVI values were comparable in elective lumbar disc herniation surgery with general and spinal anesthesia. Both groups exhibited significant a PVI decrease at T2 after 250 mL of fluid loading, indicating fluid responsiveness. In general anesthesia, the prone position showed a lower MAP and higher PI values compared to spinal anesthesia. PVI and PI, sensitive to general anesthesia changes, could have beneficial additions to standard hemodynamic monitoring in spinal anesthesia management.
本研究旨在评估全身麻醉和脊髓麻醉下接受腰椎间盘突出症手术患者的 pleth 变异指数（PVI），探讨其与液体反应性、体位和血流动力学参数的相关性。方法：本前瞻性研究纳入了 88 例年龄在 18 - 65 岁、ASA 分级为 1 - 2 级、接受 1 - 3 小时择期腰椎间盘突出症手术的患者。在特定时间点观察 GA 组和 SA 组患者的人口统计学、手术和血流动力学参数。（3）结果：GA 组和 SA 组的 PVI 值具有可比性。在输注 250 mL 液体后，两组在 T2 时基础 PVI 均显著降低。GA 组俯卧位时的 PI 值高于 SA 组。从俯卧位转为仰卧位时 PVI 保持不变，而脉搏和平均动脉压（MAP）降低。；（4）结论：在全身麻醉和脊髓麻醉下进行的择期腰椎间盘突出症手术中，PVI 值具有可比性。两组在输注 250 mL 液体后 T2 时 PVI 均显著降低，表明具有液体反应性。在全身麻醉中，与脊髓麻醉相比，俯卧位时 MAP 较低，PI 值较高。PVI 和 PI 对全身麻醉变化敏感，可为脊髓麻醉管理中的标准血流动力学监测提供有益补充。
