Evaluation of Hemodynamic Changes and Fluid Response during Anesthesia in Lumbar Disc Hernias with Pleth Variability Index (PVI)

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Sarıhan S., Koyuncu T., Kazancıoğlu L., Batçık Ş., Kazdal H.

JOURNAL OF PERSONALIZED MEDICINE, vol.14, no.3, pp.247-257, 2024 (SCI-Expanded)

  • Publication Type: Article / Article
  • Volume: 14 Issue: 3
  • Publication Date: 2024
  • Doi Number: 10.3390/jpm14030247
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Directory of Open Access Journals
  • Page Numbers: pp.247-257
  • Recep Tayyip Erdoğan University Affiliated: Yes


The study aimed to assess the pleth variability index (PVI) in patients undergoing lumbar

disc herniation surgery under general and spinal anesthesia, exploring its correlation with fluid

responsiveness, position, and hemodynamic parameters. Methods: This prospective study included

88 ASA 1–2 patients, aged 18–65, undergoing 1–3 h elective lumbar disc herniation surgery. Patients

in groups GA and SA were observed for demographic, operative, and hemodynamic parameters

at specified time points. (3) Results: PVI values were comparable between the GA and SA groups.

After 250 mL of fluid loading, both groups showed a significant decrease in basal PVI at T2. Prone

positions in GA exhibited higher PI values than in SA. The transition from a prone to supine position

maintained PVI, while pulse and MAP decreased.; (4) Conclusions: PVI values were comparable in

elective lumbar disc herniation surgery with general and spinal anesthesia. Both groups exhibited

significant a PVI decrease at T2 after 250 mL of fluid loading, indicating fluid responsiveness. In

general anesthesia, the prone position showed a lower MAP and higher PI values compared to spinal

anesthesia. PVI and PI, sensitive to general anesthesia changes, could have beneficial additions to

standard hemodynamic monitoring in spinal anesthesia management.

Keywords: pleth variability index; general anesthesia; spinal anesthesia; perfusion index; prone

position; lumbar disc hernia surgery