The change in perfusion index between supine and 45° semi-recumbent positions predicted post-induction hypotension with an AUC of 0.824, where a change greater than 22.0% yielded 72.5% sensitivity.
Observational (n=96)
No
Does the change in perfusion index between supine and 45° semi-recumbent positions predict post-induction hypotension in adults undergoing elective general anesthesia?
A change in perfusion index greater than 22.0% between supine and 45° semi-recumbent positions is a reliable predictor of post-induction hypotension during general anesthesia.
Effect estimate: OR 1.126 (95% CI 1.036-1.224)
p-value: p=0.005
Post-induction hypotension (PIH) is a common complication during general anesthesia. Perfusion index (PI), a non-invasive indicator reflecting peripheral tissue perfusion and hemodynamic status, has shown potential predictive value for PIH. We hypothesized that the change of PI (PI) between supine and 45° semi-recumbent positions can predict PIH in patients undergoing elective general anesthesia, and a cut-off value of PI for identifying a higher risk of PIH can be determined. This prospective observational study enrolled eligible adults with American Society of Anesthesiologists (ASA) physical status I–III undergoing elective surgery under general anesthesia. Before anesthesia induction, the PI of each patient was recorded after a period of supine rest to achieve hemodynamic stability; subsequently, PI was measured again after achieving stability in the 45° semi-recumbent position. PI between the two positions was calculated for analysis. PIH was defined as systolic blood pressure (SBP) 30\% from baseline within 15 minutes after anesthesia induction. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of PI for PIH, including calculation of the area under the curve (AUC), optimal cut-off value, sensitivity, and specificity. Data from 96 patients were analyzed. After anesthesia induction, 51 patients (53. 1%) developed PIH. The AUC of PI for predicting PIH was 0. 824 (95% CI: 0. 741–0. 908). The optimal cut-off value of PI was 22. 0%, which yielded a sensitivity of 72. 5% and a specificity of 86. 7%. This study was registered in the Clinical Trial Registry of China on 17/12/2024 (ChiCTR2400094135). The PI between supine and 45° semi-recumbent positions was a reliable predictor of post-induction hypotension after general anesthesia induction, wherein PI greater than 22. 0% was the threshold.
Li et al. (Tue,) conducted a observational in Post-induction hypotension (PIH) during general anesthesia (n=96). Change in perfusion index (∆PI) between supine and 45° semi-recumbent positions vs. Static baseline perfusion index was evaluated on Post-induction hypotension (SBP < 90 mmHg, MAP < 65 mmHg, or MAP reduction > 30% from baseline) (OR 1.126, 95% CI 1.036-1.224, p=0.005). The change in perfusion index between supine and 45° semi-recumbent positions predicted post-induction hypotension with an AUC of 0.824, where a change greater than 22.0% yielded 72.5% sensitivity.