Finger-cuff and oscillometric versus intra-arterial blood pressure measurements: a prospective method comparison study in patients having noncardiac surgery

BACKGROUND: Arterial blood pressure monitoring is mandatory in all patients having surgery. Intra-arterial blood pressure monitoring is the gold standard but is invasive and associated with complications. In most surgical patients, blood pressure therefore is monitored with intermittent upper-arm cuff oscillometry. Finger-cuff systems allow noninvasive continuous blood pressure monitoring, but their performance remains insufficiently studied. We therefore aimed to simultaneously compare finger-cuff and oscillometric with intra-arterial blood pressure measurements in patients having low- to moderate-risk noncardiac surgery. METHODS: In this single-centre prospective method comparison study, we simultaneously measured finger-cuff (test method), oscillometric (test method), and intra-arterial (reference method) blood pressures in patients ≥18 yr old having elective low- to moderate-risk noncardiac surgery with general anaesthesia at the University Medical Center Hamburg-Eppendorf, Hamburg, Germany. We quantified the agreement using Bland-Altman analyses. RESULTS: In total, 76 patients with 2577 triplets of blood pressure measurements were analysed. For mean blood pressure, the mean difference ± standard deviation of the differences (95% limits of agreement) was -2.8 ± 6.9 (-16.3 to 10.7) mm Hg between finger-cuff and intra-arterial measurements and 2.1 ± 8.9 (-15.3 to 19.5) mm Hg between oscillometric and intra-arterial measurements. CONCLUSIONS: In patients having low- to moderate-risk noncardiac surgery, the agreement between finger-cuff and intra-arterial blood pressure measurements was comparable with the agreement between oscillometric and intra-arterial blood pressure measurements. CLINICAL TRIAL REGISTRATION: NCT06602089.