Clinical observation on perfusion index for detection of noxious stimuli in pediatric patients under general anesthesia / 上海交通大学学报（医学版）

ABSTRACT

Objective: To observe the changes of perfusion index (PI), bispectral index (BIS), heart rate (HR), systolic blood pressure (SBP) and respiratory rate (RR) under pulling stimuli in children undergoing open inguinal hernia repairs with spontaneous ventilation, so as to evaluate the clinical value of PI in monitoring the stress response. Methods: Thirty children undergoing selective open inguinal hernia repairs with American Society of Anesthesiologists (ASA) physical status I or II were recruited. Anesthesia was induced with fentanyl and propofol, and was maintained with sevoflurane after the insertion of laryngeal mask. The PI, BIS, HR, SBP and RR were observed at the following time points before induction of anesthesia (T0), before pulling hernia sac (T1), at the time point of pulling hernia sac (T2), 1 min after pulling hernia sac (T3) and 5 min after pulling hernia sac (T4). Results: Compared with the baseline level at T0, the PI value at T1, T3 and T4 increased significantly (P=0.000, P=0.033 and P=0.000, respectively). The BIS, HR and SBP values at T1-T4 were significantly lower than baseline levels at T0 (all P=0.000). The PI values at T2 and T3 reduced significantly compared with T1. The HR value at T2 was significantly higher than that of T1 (P=0.033). Compared with the SBP values at T1, the SBP values at T3 and T4 were significantly higher (P=0.000 and P=0.011, respectively). And the RR values at T2 and T3 were higher than that at T1 (both P=0.000). The proportion of children with positive stress response based on PI was significantly higher than that based on other variables (all P=0.000). Conclusion: Perfusion index can reflect the noxious stimuli of the pulling hernia sac effectively and immediately.