Efficacy of noninvasive pulse co-oximetry as compared to invasive laboratory-based hemoglobin measurement during spinal anesthesia

Anesthesia and Pain Medicine 2014³â 9±Ç 4È£ p.277 ~ p.281

Á¤ÁøÇå(Chung Jin-Hun) - Soonchunhyang University College of Medicine Department of Anesthesiology and Pain Medicine
ÁöÀ翵(Ji Jae-Young) - Soonchunhyang University College of Medicine Department of Anesthesiology and Pain Medicine
±è³­¼³(Kim Nan-Seol) - Soonchunhyang University College of Medicine Department of Anesthesiology and Pain Medicine
¼­¿ëÇÑ(Seo Yong-Han) - Soonchunhyang University College of Medicine Department of Anesthesiology and Pain Medicine
°øÇüÀ±(Gong Hyung-Youn) - Soonchunhyang University College of Medicine Department of Anesthesiology and Pain Medicine
±èÀç¿ì(Kim Jae-Woo) - Soonchunhyang University College of Medicine Cheonan Hospital Department of Emergency Medicine
±èÁ¾ºÐ(Kim Jong-Bun) - Catholic University Uijeongbu St. Mary¡¯s Hospital Department of Anesthesiology and Pain Medicine
À¯½ÃÇö(Yoo Sie-Hyeon) - Soonchunhyang University College of Medicine Department of Anesthesiology and Pain Medicine

Abstract

Background: The Masimo Radical 7 (Masimo Corp., Irvine, CA, USA) pulse co-oximeter¨Þ noninvasively determines the hemoglobin concentration using the principle of transcutaneous spectrophotometry. We compared hemoglobin levels determined using this device (SpHb) with those determined using an invasive laboratory-based technique (tHb) during spinal anesthesia.

Methods: Thirty patients received spinal anesthesia with 0.5% hyperbaric bupivacaine. The pulse co-oximeter probe was mounted on the second toe, and arterial blood samples were obtained from a radial artery catheter. SpHb, tHb, and perfusion index (PI) values were recorded before and 20 and 40 min after intrathecal injection of bupivacaine.

Results: Before spinal anesthesia, the SpHb and tHb showed a significant difference of ?2.86 ¡¾ 1.56 g/dl (P £¼ 0.005), but no significant differences were found between tHb and SpHb at 20 and 40 min after spinal anesthesia (?0.16 ¡¾ 2.45 g/dl and 0.29 ¡¾ 2.68 g/dl). Additionally, PI was significantly increased at 20 and 40 min after spinal anesthesia compared to the pre-anesthetic value (P £¼ 0.001).

Conclusions: The toe is not the monitoring site for pulse co-oximetry in adult patients, but the pulse co-oximetry on the toe appears to be appropriate as a noninvasive hemoglobin monitoring device after spinal anesthesia. (Anesth Pain Med 2014; 9: 277-281)

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Hemoglobin, Pulse co-oximetry, Spinal anesthesia
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