Application of pleth variability index monitoring in patients receiving laparoscopic cholecystectomy / 第二军医大学学报

ABSTRACT

Objective To study the changes of pleth variability index (PVI) in patients receiving laparoscopic cholecystectomy under general anesthesia, and to investigate the clinical influencing factors of pre-operation baseline PVI value. Methods Totally 67 patients undergoing laparoscopic cholecystectomy with ASA?-II, aged 18 to 65 years old, were included in the present study. The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse oximetry (SpO2), perfusion index (PI), and PVI value were monitored with a Masimo pulse oxygen monitor (Radical-7, USA) after entering the operation room. Fluid expansion with 10 mL/kg of balanced solution was given before the induction. Anesthesia was maintained under total intravenous anesthesia (TIVA) with propofol and remifentanil. Results The average baseline PVI value was (16.8±6.3)% in the patients; then it decreased to (10.3±5.4)% after induction of anesthesia and increased to (21.2±9.5)% after establishment of pneumoperitoneum. The pre-operation baseline PVI value (\[19.2±6.5\] %) of patients <45 years old was significantly higher than that in patients ≥45 years old (\[15.5±5.9\]%, P<0.05%). Male patients had a significantly higher PVI (\[18.8±7.5\]%) value than female patients (\[15.3±4.8\]%, P<0.05). Body mass index (BMI) was not significantly associated with pre-operation baseline PVI. Conclusion The baseline value of PVI is higher than 14%, suggesting insufficient volume load in most of patients. Age and sex are both associated with pre-operation PVI value male patients and those <45 years old have a higher pre-operation baseline PVI value.