Perfusion index as a possible predictor for postanesthetic shivering

Kuroki, Chiharu; Godai, Kohei; Hasegawa-Moriyama, Maiko; Kuniyoshi, Tamotsu; Matsunaga, Akira; Kanmura, Yuichi; Kuwaki, Tomoyuki

doi:10.1007/s00540-013-1658-9

Cited by 17 publications

(24 citation statements)

References 24 publications

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“…Measurement tools included the Demographic Questionnaire, comprising 5 items on personal attributes (sex, height, weight, body mass index, and ASA classification score) and 9 on medical management (preoperative temperature, preoperative systolic blood pressure, preoperative diastolic blood pressure, preoperative haemoglobin, intraoperative temperature, flushing volume, total volume of infused fluid, operation time, and duration of anaesthesia), and the Complications Questionnaire, in 4 parts. First, shivering was scored using a visual scale (Kuroki et al, ; Yeh et al, ) as follows: 0, no visible or palpable shivering; 1, palpable and visible shivering or noise on the electrocardiogram; 2, visible shivering of the face and neck; 3, visible shivering of the chest or torso; and 4, generalized shivering with or without chattering teeth. Second, subjective feeling of pain (Reips & Funke, ) was scored from 0 to 10 using a visual analogue scale.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of forced‐air warming for preventing perioperative hypothermia and related complications in patients undergoing laparoscopic surgery: A randomized controlled trial

Nieh

2018

Int J of Nursing Practice

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Section: Methodsmentioning

confidence: 99%

Efficacy of forced‐air warming for preventing perioperative hypothermia and related complications in patients undergoing laparoscopic surgery: A randomized controlled trial

Nieh

2018

Int J of Nursing Practice

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“…Post-operative shivering can be divided into thermoregulatory and non-thermoregulatory [ 29 ], and it can be triggered by surgical stress and several aspects of anesthetic management. It is frequently preceded by a decrease in peripheral blood flow due to thermoregulatory vasoconstriction [ 30 ]. Hypothermia causes thermoregulatory shivering; the expansion of blood vessels leads to lower body temperature caused by heat loss after neuraxial anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Intrathecal Sufentanil Does Not Reduce Shivering During Neuraxial Anesthesia: A Meta-Analysis

et al. 2016

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BackgroundWe performed this meta-analysis to evaluate the efficacy of intrathecal sufentanil in preventing shivering during neuraxial anesthesia.Material/MethodsWe searched the Cochrane Library, PubMed, and Embase for all randomized controlled trials (RCT) on use of intrathecal sufentanil for preventing shivering during neuraxial anesthesia. References of retrieved articles were also screened. The quality of the studies was evaluated by the method recommended by the Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration’s RevMan 5.3 software. The primary outcome was incidence and severity of shivering, and the secondary outcomes were drug-related complications of pruritus, nausea, vomiting, hypotension, and bradycardia.ResultsEight original RCTs investigating a total of 1032 patients, of whom 599 received sufentanil and 473 received placebo, met the inclusion criteria. Compared to the placebo group, sufentanil did not reduce incidence of shivering (OR, 0.60; 95% CI, 0.35 to 1.01; P=0.06), but it increased the incidence of pruritus (OR, 12.52; 95% CI, 5.07 to 30.91; P<0.00001). Compared to the placebo group, sufentanil did not increase the incidence of nausea (OR, 0.69; 95% CI, 0.41 to 1.16; P=0.16), hypotension (OR, 0.93; 95% CI, 0.62 to 1.41; P=0.74), or bradycardia (OR, 0.86; 95% CI, 0.41 to 1.82; P=0.70). In addition, sufentanil reduced the incidence of vomiting during neuraxial anesthesia (OR, 0.45; 95% CI, 0.22 to 0.92; P=0.03).ConclusionsNeither epidural nor subarachnoid intrathecal sufentanil reduced shivering during neuraxial anesthesia, but it did increase the incidence of pruritus.

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“…The perfusion index (PI) has been shown to reflect changes in peripheral circulation perfusion [8]. Peripheral perfusion is influenced by cardiac output (CO) and peripheral vasomotor tone [9] and is sensitive to sympathetic vasoconstriction and skin temperature [10,11]. The PI might be used as a surrogate of CO if sympathetic tone and skin temperature are kept stable.…”

Section: Introductionmentioning

confidence: 99%

The effects of hemodynamic management using the trend of the perfusion index and pulse pressure variation on tissue perfusion: a randomized pilot study

2019

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Background: Intraoperative hemodynamic management is challenging because precise assessment of the adequacy of the intravascular volume is difficult during surgery. Perfusion index (PI) has been shown to reflect changes in peripheral circulation perfusion. Pulse pressure variation (PPV) reflects the preload responsiveness. The hypothesis of this study was that hemodynamic management using the trend of the PI and PPV would improve tissue perfusion. Methods: This was a prospective, randomized, parallel design, single-blind, single-center pilot study. Patients undergoing elective open gynecological surgery requiring a direct arterial line were included. The patients were randomly allocated to two groups. The intervention group received hemodynamic management using the trend of the PI and PPV in an effort to improve tissue perfusion. The control group received hemodynamic management at the discretion of the anesthesia care provider. The primary outcome was the peak lactate level during surgery. The secondary outcomes were the duration of hypotension, intraoperative fluid balance, intraoperative urine output, and postoperative complication rate. Statistical analysis was performed using Student's t test and Fisher's exact test. A P value of < 0.05 was considered statistically significant. Results: Although the intervention significantly decreased the duration of hypotension and intraoperative fluid balance, the peak lactate level was not different between the intervention group and the control group. Intraoperative urine output and postoperative complication rate were not different between the groups. Conclusion: Hemodynamic management using the trend of the PI and PPV does not improve tissue perfusion in patients undergoing open gynecological surgery. Trial registration: This trial was prospectively registered on a publicly accessible database (UMIN Clinical Trials Registry ID: UMIN 000026957. Registered 12 April 2017, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view. cgi?recptno=R000030916).

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Perfusion index as a possible predictor for postanesthetic shivering

Abstract: Perfusion index was significantly lower in patients with postanesthetic shivering before emergence from anesthesia, indicating that measurement of perfusion index during and before the end of anesthesia might be a useful means of predicting postanesthetic shivering.

Cited by 17 publications

References 24 publications

Efficacy of forced‐air warming for preventing perioperative hypothermia and related complications in patients undergoing laparoscopic surgery: A randomized controlled trial

Efficacy of forced‐air warming for preventing perioperative hypothermia and related complications in patients undergoing laparoscopic surgery: A randomized controlled trial

Intrathecal Sufentanil Does Not Reduce Shivering During Neuraxial Anesthesia: A Meta-Analysis

The effects of hemodynamic management using the trend of the perfusion index and pulse pressure variation on tissue perfusion: a randomized pilot study

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