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KMID : 0381219860180040353
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Journal of RIMSK
1986 Volume.18 No. 4 p.353 ~ p.361
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Measurement of Perfusion States with Photoplethysmography in the Finger
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Abstract
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The maintenance of adequate tissue perfusion in perioperative period is the practical concern to anesthesiologist. Many methods have been used to evaluate peripheral perfusion. To measure blood flow in the finger, we used finger pulse sensor, also called photoplethysmography. Pulse amplitudes were obtained in horizontal, upward, heart level and downward positions of upper arm. The results were as followed ;
1) In normal adults, I divided 3 groups according to the vascular response in upward position of upper arm.
(1) In the low response group(under -25% of control value) : Pulse amplitude was decreased in upward position (33±27%) and downward position (39±28%).
(2) In the moderate response group(between ±25% of control value) : Pulse amplitude was decreased in downward position (22±22%).
(3) In the high response group(over +25%of control value) : Pulse amplitude was increased in upward position (173±38%) and also increased at heart level (130±36%), but decreased in the downward position.
2) In 40 patients, I also divided 3 groups.
(1) In the low response group: Pulse amplitude was decreased in the heart level and downward position. With anesthesia, pulse amplitude was decreased in horizontal & upward arm positions.
(2) In the moderate response group: Pulse amplitude was increased in upward & heart level and decreased in downward position
(3) In the high response group: Pulse amplitude was increased in upward (167±32%) & heart level (144±35%), but decreased in downward position (47±29%). With anesthesia, pulse amplitude was increased in horizontal Position (163±44%).
The data indicate that perfusion states were poor in downward position of upper arm. I think preoperative evaluation are necessary for low response group in the case of upward arm position. Generally, heart level of upper arm is desired for adequate perfusion. The effects of anesthesia to peripheral circulation are various according to the depth & kinds of anesthesia. With the induction of anesthesia, pulse amplitude was increased in the horizontal position of group II.
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