title: Responses of the second derivative of the finger photoplethysmogram indices and hemodynamic parameters to anesthesia induction.
abstract: The finger photoplethysmogram (PTG) is a non-invasive method for pulse-wave analysis. The second derivative wave of the PTG (SDPTG) enables evaluation of atherosclerosis and cardiovascular aging. Responses of SDPTG indices and hemodynamic parameters to anesthesia induction are unknown. A total of 42 patients aged 40 years, who may have had atherosclerotic change, and who underwent elective oral surgery, were analyzed. Patients were divided into sevoflurane (S group; N=22) and sevoflurane with remifentanil (R group; N=20) groups. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR) and SDPTG were measured at four time points: before induction, after loss of consciousness, after tracheal intubation and 30 min after induction. At postintubation, b/a was elevated (that is, large arterial stiffness was increased), and d/a was reduced (that is, peripheral vascular resistance was increased) in the S group compared with the R group. SBP, DBP and HR were increased in the S group compared with those in the R group. In the S group, preanesthetic b/a and the aging index (AGI) were positively correlated with SBP at immediate postintubation, and preanesthetic d/a was negatively correlated with SBP and DBP at immediate postintubation. It is suggested that usage of remifentanil, a potent μ-opioid analgesic, with sevoflurane anesthesia prevented an increase in blood pressure and HR in response to laryngoscopy and tracheal intubation, which was accompanied by suppression of both elevation of b/a and the AGI and reduction of d/a. SDPTG indices are useful for predicting hypertension during induction of sevoflurane anesthesia, regardless of a history of hypertension or hypertensive factors.
authors.affiliation: Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. atsushik@dent.kagoshima-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kohjitani
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyata
authors.forename: Yoko
authors.initials: Y
authors.lastname: Iwase
authors.forename: Kazuna
authors.initials: K
authors.lastname: Sugiyama
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D000758:Anesthesia; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D019540:Area Under Curve; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D019647:Oral Surgical Procedures; D017156:Photoplethysmography / Q000706:statistics & numerical data*; D010880:Piperidines / Q000494:pharmacology; D012372:ROC Curve; D012039:Regional Blood Flow / Q000502:physiology; D000077208:Remifentanil; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil