Zifeng Xu1, Jianhai Zhang2, Yunfei Xia2, Xiaoming Deng3. 1. Department of Anesthesiology, International Peace Maternal and Child Health Hospital, Shanghai Jiaotong University China. 2. Department of Anesthesiology, Shanghai First People's Hospital, Shanghai Jiaotong University Shanghai, China. 3. Department of Anesthesiology, Changhai Hospital, Second Military Medical University Shanghai, China.
Abstract
OBJECTIVE: To observe the change of PVI after thoracic epidural block on the basis of general anesthesia. METHODS: In 26 patients undergoing elective upper abdominal operations, changes of SVI, PVI, SVV, PPV and CVP were monitored immediately before and 10 minutes after T8-9 thoracic epidural anesthesia on the basis of general anesthesia. The definition was that patients with ΔSVI greater than 10% belonged to response group to epidural block. RESULTS: Before epidural block, the PVI, SVV and PPV baseline values in patients of response group were significantly higher than those in patients of non-response group. PVI, SVV and PPV after epidural block were significantly higher than immediately before epidural block (P < 0.001). PVI, SVV and PPV baseline values immediately before epidural block were positively correlated with ΔSVI; the correlation coefficients were 0.70, 0.71 and 0.63, respectively, P ≤ 0.001. The optimal critical values for PVI, SVV and PPV to predict response to T8-9 gap epidural block under general anesthesia were 16% (sensitivity 80%, specificity 92%), 13% (sensitivity 90%, specificity 62%) and 12% (sensitivity 90%, specificity 77%), respectively. CONCLUSION: PVI can be used as a noninvasive indictor to monitor volume change after thoracic epidural block on the basis of general anesthesia.
OBJECTIVE: To observe the change of PVI after thoracic epidural block on the basis of general anesthesia. METHODS: In 26 patients undergoing elective upper abdominal operations, changes of SVI, PVI, SVV, PPV and CVP were monitored immediately before and 10 minutes after T8-9 thoracic epidural anesthesia on the basis of general anesthesia. The definition was that patients with ΔSVI greater than 10% belonged to response group to epidural block. RESULTS: Before epidural block, the PVI, SVV and PPV baseline values in patients of response group were significantly higher than those in patients of non-response group. PVI, SVV and PPV after epidural block were significantly higher than immediately before epidural block (P < 0.001). PVI, SVV and PPV baseline values immediately before epidural block were positively correlated with ΔSVI; the correlation coefficients were 0.70, 0.71 and 0.63, respectively, P ≤ 0.001. The optimal critical values for PVI, SVV and PPV to predict response to T8-9 gap epidural block under general anesthesia were 16% (sensitivity 80%, specificity 92%), 13% (sensitivity 90%, specificity 62%) and 12% (sensitivity 90%, specificity 77%), respectively. CONCLUSION:PVI can be used as a noninvasive indictor to monitor volume change after thoracic epidural block on the basis of general anesthesia.
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