Comparison of perfusion index (PI) with other non-invasive hemodynamic monitors of stress response following endotracheal intubation

Abstract

Aims and Objective: Aim of the present study was to evaluate efficacy of perfusion index as a non-invasive monitor of hemodynamic responses in comparison to heart rate and blood pressure following insertion of endotracheal tube. Material and Method: The study enrolling 60 patients of either sex, age between 18-60 years, ASA grade I and II were scheduled for elective surgery under general anesthesia. Anesthesia was induced with intravenous fentanyl 1-2?g/kg, propofol 2.5 mg/kg and rocuronium 0.6 mg/kg. After adequate relaxation intubation of the trachea with a cuffed tracheal tube using direct laryngoscopy was done. Heart rate, noninvasive blood pressure and perfusion index were measured before (baseline values) induction and intubation and after intubation at 1minute, 3minute and 5 minute before starting the surgery. Results: Insertion of the device produced significant increases in heart rate (of ?10 bpm) and noninvasive blood pressure (of ?15 mm Hg) whereas perfusion index was decreased significantly by ?10%. We found PI response criterion achieve sensitivity of 96.7 % (CI: 88.5-99.6) for detecting the stress response to endotracheal intubation during balanced anaesthesia in adult patients. On other hand SBP and DBP achieved sensitivity of 55.1% (CI: 45.2-64.6) and 63.7 % (CI: 52.7-72.8) respectively. Conclusions: Perfusion index was reliable indicator for stress response for endotracheal intubation with better sensitivity and specificity as compared to heart rate and blood pressure.