Relationship Between Peripheral Perfusion Index and Anxiety

Peripheralperfusionindex(PI) provides information about vascular tone and fluid status by interpreting the data obtained from pulse oximetry. However, the vascular tone may be affected by anxiety in patients. Impaired perfusion index in patients with high anxiety may cast a shadow on the predictive power of the PI. In the present study, we aimed to evaluate the relationship between anxiety and perfusion index values. Preoperatively, anxiety scores of the patients were measured by APAIS and STAI tests. Perfusion index values were also recorded in the preoperative room. The correlation between these values was evaluated. 95 patients aged 18-65 years were included in the present study. Mean anxiety scores of all patients were 48.354.42. Perfusion index values were significantly lower in the patients with higher anxiety. In addition, we have found a negative and significant correlation between anxiety and perfusion index. The perfusion index is a non-invasive, easy to apply and cost-effective method. It has been used in the important studies such as predicting the development of hypotension induced by anesthesia. However, according to the results of our study, this technique is affected by the anxiety levels of the patients. It may be misleading in patients whose anxiety is not obvious. Anxiety levels should be questioned in awake patients and it should be kept in mind that perfusion index may decrease in high anxiety levels.

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1. Masimo Corp, “Clinical Applications of Perfusion Index Perfusion Index Clinical Interpretation of the Perfusion Index,” 2016; 1-6.

2. Yamazaki H, Nishiyama J, Suzuki T, “Use of perfusion index from pulse oximetry to determine efficacy of stellate ganglion block,” Local Reg Anesth 2012; 5: 9-14.

3. Loupec T, Nanadoumgar H, Frasca D, et al. “Pleth variability index predicts fluid responsiveness in critically ill patients,” Crit. Care Med 2011; 294-299.

4. Kain Z. N, Maranets I. “Preoperative Anxiety and Intraoperative Anesthetic Requirements,” Anesth. Analg 2000; 89: 1346-1351.

5. Kalkman C.J, Visser K, Moen J, et al. “Preoperative prediction of severe postoperative pain,” Pain 2003; 105: 415-423.

6. Yokose M, Mihara T, Sugawara Y, Goto T, “The predictive ability of non-invasive haemodynamic parameters for hypotension during caesarean section: A prospective observational study,” Anaesthesia 2015; 70: 555-562.

7. Choi SB, Park JS, Chung JW, Kim SW, Kim D. W, “Prediction of ATLS hypovolemic shock class in rats using the perfusion index and lactate concentration,” Shock, 2015; 43: 361-368.

8. Hager H, Reddy D, Kurz A, “perfusion index- A valuable Tool to Assess Changes in Peripheral Perfusion Caused By Sevoflurane?,” Anestesiology 2003; 99: 553.

9. Amiya E, Watanabe M, Komuro I. “The Relationship between Vascular Function and the Autonomic Nervous System,” Ann. Vasc. Dis 2014; 7: 109-119.

10. Spielberger C. D, Manual for the State-Trait Anxiety Inventory (Form Y1 – Y2), IV. palo alto, CA: Consulting Psychologists Press 1983.

11. Renzi D. A, “State-Trait Anxiety Inventory,” Meas. Eval. Couns. Dev 2018.

12. Broch O, Bein B, Gruenewald M. et al. “Accuracy of the pleth variability index to predict fluid responsiveness depends on the perfusion index,” Acta Anaesthesiol. Scand 2011; 55: 686-693.

13. Toyama S, Kakumoto M, Morioka M, et al. “Perfusion index derived from a pulse oximeter can predict the incidence of hypotension during spinal anaesthesia for Caesarean delivery,” Br. J. Anaesth 2013; 111: 235-241.

14. Stamenkovic DM, Rancic NK, Latas MB. et al. “Preoperative anxiety and implications on postoperative recovery: What can we do to change our history,” Minerva Anestesiologica 2018; 84: 1307-1317.

15. Laufenberg-Feldmann R, Kappis B, Schuster M, Ferner M. “Relevance of preoperative anxiety for postoperative outcome in urological surgery patients: A prospective observational study,” Schmerz 2016; 30: 166-173.

16. Bakı ED, Ulu S, Yüksek A, Arlcan H, Sıvacı R, “Does Listening to Music during Tonsillectomy Affect Sevoflurane Consumption?,” Med. Princ. Pract 2018; 27: 343-349.

17. Caumo W, Schimdt AP,Schineider CN et al., “Risk factors for preoperative anxiety in adults,” Acta Anaesthesiol. Scand 2001; 45: 298-307.

18. Sigdel DS, “Perioperative anxiety: A short review,” Glob. Anesth. Perioper. Med 2015; 1: 107-108.

19. Ayada C, Toru Ü, Korkut Y, “The relationship of stress and blood pressure effectors,” Hippokratia 2015; 19: 99-108.

20. Zhang DY, Anderson AS, “The Sympathetic Nervous System and Heart Failure David,” Cardiol Clin 2016; 25: 289-313.

21. Aykent R, Kocamanoglu IS, Ustun E, Tur A, Sahinoglu H, “The reasons and evaluation of preoperative anxiety: a comparison of APAIS and STAI scores.,” Turkiye Klin. J. Anesthesiol. Reanim 2007; 5: 7-13.