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Perfusion Index as an Objective Tool to Assess Analgesia During Laparoscopic Surgeries under General Anaesthesia: A Prospective Study

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Dr Sakshi Gupta, Dr Anju Jamwal, Dr Updesh Kumar, Dr Anurati Raina, Dr Shipra Gupta
» doi: 10.31838/ecb/2023.12.si6.331


Despite the use of analgesics, many patients experience pain during and after laparoscopic surgery, which can lead to negative outcomes such as prolonged hospital stays, increased morbidity and mortality, and decreased patient satisfaction. Pain can change the sympathetic nervous system, which can impair perfusion and smooth muscle tone. Perfusion index is a tool for monitoring (PI). It is a non-invasive, indirect, and continuous indicator of peripheral perfusion. This study examines how painful stimuli under general anaesthesia alter PI. Methods: The present study was conducted at the post graduate Department of Anaesthesia, GMC, Jammu with effect from September 2021 to Feb 2022. After receiving approval from the institutional ethics committee, a total of 50 patients of either sex, 20–45 years old, belonging ASA I classification, and scheduled for laparoscopic cholecystectomy were included in this study. Results: We observed that after the administration of fentanyl, the PI values increased from 5.17±3.23 at P1 to 6.15±3.37 at P2 as shown in table 1. With an increasing trend, PI values reached to 6.41 at P3 then decreased to 5.75 at 5 minutes and increased gradually to reach 6.19 at 30 minutes. after the administration of fentanyl, SBP, DBP and MAP readings decreased from (117.31±19.14) mmHg, (73.96±12.22) mmHg, and (88.41±12.88) mmHg at P1 respectively, to (115.90±12.14) mmHg, (73.58±10.93) mmHg, and (87.69±11.57) mmHg at P2 respectively. With a decreasing trend, SBP, DBP and MAP reached to (114.79±14.01) mmHg, (73.02±11.39) mmHg, and (86.94±10.7) mmHg respectively. Conclusion: The results of the present study demonstrated that PI can be used as a non-invasive, objective tool to assess the effectiveness of analgesia during laparoscopic surgeries under GA. PI values can be used together with vital signs such as HR, SBP, DBP, and MAP to guide the administration of opioids and other analgesics to prevent side effects and maintain patient comfort.

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