Evaluation of Preoperative Perfusion Index Measurement to Predict Propofol-Related Hypotension in Procedural Sedation

INTRODUCTION: Hypotension is a common problem during colonoscopy with procedural sedation. Perfusion index (PI) has been shown to be predictive of hypotension following the induction of general anesthesia. We hypothesized that PI could predict hypotension during colonoscopy and that a cut-off value could be determined at which hypotension is more common.
METHODS: One hundred and fifty adults belonging to the American Society of Anesthesiologists' physical status I/II, undergoing elective colonoscopy under procedural sedation with propofol, were enrolled in this prospective, observational study. PI, heart rate, blood pressure, and oxygen saturation were recorded during colonoscopy. Hypotension was defined as a mean arterial pressure (MAP) of <65 mmHg.
RESULTS: The incidence of hypotension with predefined MAP criteria was 13%. Baseline PI <1.9 predicted any episode of hypotension with a sensitivity of 73.7%, specificity of 59.3%, positive predictive value (PPV) of 32.5%, and negative predictive value (NPV) of 89%. The area under the ROC curve (AUC) was 0.651 (95% confidence interval: 0.567–0.729, p=0.0275).
DISCUSSION AND CONCLUSION: The perfusion index could be a potential parameter to predict hypotension during propofol sedation. It had a moderately high sensitivity value and a very high negative predictive value.