Correlation between the Perfusion Index and Intraoperative Hypothermia: A Prospective Observational Pilot Study

Background and Objectives: We examined the association between the baseline perfusion index (PI) and changes in intraoperative body temperature during general anesthesia. The PI reflects the peripheral perfusion state. The PI may be associated with changes in body temperature during general anesthesia because the degree of redistribution of body heat from the central to the peripheral compartment varies depending on the peripheral perfusion state. Materials and Methods: Thirty-eight patients who underwent brain surgery were enrolled in this study. The baseline PI and body temperature of the patients were measured on entering the operating room. Body temperature was recorded every 15 min after induction of anesthesia using an esophageal temperature probe. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for intraoperative hypothermia. Results: Eighteen patients (47 %) developed hypothermia intraoperatively. The baseline PI was significantly lower among patients in the hypothermia group (1.8 ± 0.7) than among those in the normothermia group (3.0 ± 1.2) (P < 0.001). The baseline PI and body temperature were independently associated with intraoperative hypothermia (PI: odds ratio [OR], 0.270; 95% confidence interval [CI], 0.105–0.697; P = 0.007, baseline body temperature: OR, 0.061; 95% CI, 0.005–0.743; P = 0.028). Conclusions: This study showed that low baseline PI was the factor most related to the development of intraoperative hypothermia. Future studies should consider the PI as a predictor of intraoperative hypothermia.

[1]  Jaegeum Shim,et al.  Comparison of vasodilatory properties between desflurane and sevoflurane using perfusion index: a randomised controlled trial. , 2020, British journal of anaesthesia.

[2]  Yi Feng,et al.  Prevalence and multivariable factors associated with inadvertent intraoperative hypothermia in video-assisted thoracoscopic surgery: a single-center retrospective study , 2020, BMC Anesthesiology.

[3]  J. Y. Lee,et al.  Evaluation of the Intraoperative Perfusion Index for Correlation with Acute Postoperative Pain in Patients Undergoing Laparoscopic Colorectal Cancer Surgery , 2019, Journal of clinical medicine.

[4]  A. Oudin,et al.  Mortality Related to Cold Temperatures in Two Capitals of the Baltics: Tallinn and Riga , 2019, Medicina.

[5]  J. Y. Lee,et al.  Correlation of Perfusion Index Change and Analgesic Efficacy in Transforaminal Block for Lumbosacral Radicular Pain , 2019, Journal of clinical medicine.

[6]  S. Hoka,et al.  What is the predictor of the intraoperative body temperature in abdominal surgery? , 2018, Journal of Anesthesia.

[7]  I. Kupeli,et al.  Can Perfusion Index be used as an Objective Tool for Pain Assessment in Labor Analgesia? , 2018, Pakistan journal of medical sciences.

[8]  J. Andrzejowski,et al.  Inadvertent perioperative hypothermia. , 2018, BJA education.

[9]  S. Mehandale,et al.  Perfusion index as a predictor of hypotension following propofol induction - A prospective observational study , 2017, Indian journal of anaesthesia.

[10]  Yuguang Huang,et al.  Establishment and Validation of a Prediction Equation to Estimate Risk of Intraoperative Hypothermia in Patients Receiving General Anesthesia , 2017, Scientific Reports.

[11]  A. El-adawy,et al.  Evaluation of perfusion index as a tool for pain assessment in critically ill patients , 2017, Journal of Clinical Monitoring and Computing.

[12]  E. Jeng,et al.  Perfusion Index: An Indicator of Success During Endoscopic Thoracic Sympathectomy for Hyperhidrosis. , 2017, The Annals of thoracic surgery.

[13]  A. Hasanin,et al.  Predicting successful supraclavicular brachial plexus block using pulse oximeter perfusion index , 2017, British journal of anaesthesia.

[14]  B. Bein,et al.  Warming before and after epidural block before general anaesthesia for major abdominal surgery prevents perioperative hypothermia: A randomised controlled trial , 2016, European journal of anaesthesiology.

[15]  D. Crook,et al.  Comparison of resistive heating and forced-air warming to prevent inadvertent perioperative hypothermia. , 2016, British journal of anaesthesia.

[16]  Wen‐qi Huang,et al.  Risk factors for hypothermia in patients under general anesthesia: Is there a drawback of laminar airflow operating rooms? A prospective cohort study. , 2015, International journal of surgery.

[17]  D. Sessler,et al.  Intraoperative Core Temperature Patterns, Transfusion Requirement, and Hospital Duration in Patients Warmed with Forced Air , 2015, Anesthesiology.

[18]  T. Kuwaki,et al.  Perfusion index as a possible predictor for postanesthetic shivering , 2014, Journal of Anesthesia.

[19]  C. Zhou,et al.  Oximetry-derived perfusion index as an early indicator of CT-guided thoracic sympathetic blockade in palmar hyperhidrosis. , 2013, Clinical radiology.

[20]  Y. Tagaito,et al.  Perfusion index derived from a pulse oximeter can predict the incidence of hypotension during spinal anaesthesia for Caesarean delivery. , 2013, British journal of anaesthesia.

[21]  J. Bakker,et al.  Peripheral Perfusion Index as an Early Predictor for Central Hypovolemia in Awake Healthy Volunteers , 2013, Anesthesia and analgesia.

[22]  M. Nitzan,et al.  Pulse oximeter perfusion index as an early indicator of sympathectomy after epidural anesthesia , 2009, Acta anaesthesiologica Scandinavica.

[23]  Tara Lynn Weirich Hypothermia/warming protocols: why are they not widely used in the OR? , 2008, AORN journal.

[24]  A. Takamata,et al.  Preoperative Risk Factors of Intraoperative Hypothermia in Major Surgery Under General Anesthesia , 2002, Anesthesia and analgesia.

[25]  F. Dexter,et al.  What are the Most Important Risk Factors for a Patient’s Developing Intraoperative Hypothermia? , 2002, Anesthesia and analgesia.

[26]  D. Sessler,et al.  Perioperative heat balance. , 2000, Anesthesiology.

[27]  L. Fleisher,et al.  Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. , 1997, JAMA.

[28]  A. Kurz,et al.  Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. , 1996, The New England journal of medicine.

[29]  G. Hervey Hypothermia , 1973 .

[30]  Joakim Bjorkdahl Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events , 1997 .