Can we use the ankle non-invasive blood pressure during otolaryngologic surgery: an observational study

Abstract

Introduction In otolaryngologic surgery, ankle is frequently used for monitoring anesthesia in place of brachial when the patient doesn´t need invasive arterial cannulation. If there is a clinically useful and Predictable link between the two readings in hemodynamic normal patient, this difference during otolaryngologic surgery, was not evaluated. We aimed to investigate the reliability and the acceptability of non invasive blood pressure measurements at the ankle compared to those obtained concurrently at the arm during otolaryngologic surgery. Methods Eighty ASA grade I and II patients who had to be operated under general anesthesia were taken as subjects for our study. Blood pressures were measured simultaneously in the 2 limbs before induction and then every 10 minutes until the end of the surgical procedure. Readings were initiated concurrently. Statistical analysis was performed with PASW Statistics 13. Results There were 41 males (51.2 %) and 39 females (48.8 %). Bland-Altman analysis of mean difference between the ankle and arm (95 % limits of agreement) was -11.47 (- 23.77 to 0.82) mmHg for systolic blood pressure (SBP), -7.89 (-19.16 to 3.36) mmHg for diastolic blood pressure (DBP) and - 9.09 (18.19 to 0.00) mmHg for mean arterial pressure (MAP). Non-parametric analysis showed that 67.5 % of SBP, 46.2 % of DBP and 56.2 % of MAP measurements differed by > 10mmHg. Conclusion Ankle BP cannot be used routinely in otolaryngological surgery. Although, the ankle can be used as an alternative where the arm cannot be used taking into account a difference.

Medida indireta da pressão arterial em membros inferiores: revisão integrativa

“…Dentre os 13 estudos incluídos na categoria "Comparação de valores de PA", nove deles (E01, E03, E06, E07, E09, E10, E11, E12 e E13) sugerem que medida da PA na perna seja realizada apenas em situações em que o braço não estiver disponível (DRAKE;HILL, 2013;GOLDSTEIN;WELLS;SLIWA, 2014;GOLDTHORP;CAMERON;ASBURY, 1986;HENLEY;QUATRARA;CONAWAY, 2015;MANEVAL et al, 2014;MOORE et al, 2008;SANGHERA et al, 2006;SAREEN et al, 2012;WENDKOS;ROSSMAN, 1943). Jaouhari et al (2020) realizaram um estudo para comparar a PAS no braço e no tornozelo durante cirurgias otorrinolaringológicas e os achados levaram à conclusão de que os valores de PA encontrados no tornozelo são discrepantes em relação ao braço e, portanto, não devem ser utilizados rotineiramente. Essa diferença foi menor quando observada a PAD, entretanto, a PAD isolada não tem aplicação clínica no cuidado ao paciente crítico (JAOUHARI et al, 2020).…”

“…Jaouhari et al (2020) realizaram um estudo para comparar a PAS no braço e no tornozelo durante cirurgias otorrinolaringológicas e os achados levaram à conclusão de que os valores de PA encontrados no tornozelo são discrepantes em relação ao braço e, portanto, não devem ser utilizados rotineiramente. Essa diferença foi menor quando observada a PAD, entretanto, a PAD isolada não tem aplicação clínica no cuidado ao paciente crítico (JAOUHARI et al, 2020).…”