Evaluation of hemodynamic changes and fluid response during anesthesia in lumbar disc hernias with Pleth Variability Index (PVI) prospective observational study

Purpose: The PVI values of the patients who underwent general anesthesia and spinal anesthesia in Lumbar Disc Hernia (LDH) operations; It was planned to evaluate its relationship with fluid responsiveness, position and other hemodynamic monitor parameters. Materials and methods: With the permission of Recep Tayyip Erdoğan University Non-Interventional Clinical Research Ethics Committee dated 24/06/2021 and 2021/122, patients in the ASA I-II risk group, 18-65 years old, who were planned for elective LDH surgery, were included in the prospective observational study. Patients were analyzed as Groups GA and SA. Demographic and operative data of 88 patients and T0; baseline, T1; Supine 10.min, T2-3-4-5; prone 15-30-45-60min, and T6; supine PVI,PI were recorded. Results: PVI values were found to be similar in group GA and SA. There was no significant difference in Postop T6 and baseline T0 PVI in all patients (p>0.05). After 250ml fluid loading, baseline PVI values decreased at T2 time in both groups, which was statistically significant (p=0.01). Prone T2, T3, T4, T5 PI values in Group GA were significantly higher than in Group SA (T2; p=0.02, T3-5; p=0.01, p<0.05). PVI values were similar in the transition from pron T5 to supine T6 (p>0.05). While PVI values were preserved, pulse and MAP values decreased compared to T0 (Group CI;p=0.011,Group SA;p=0.06,p<0.05) Conclusions: PVI values were similar in patients who underwent elective LDH and underwent general and spinal anesthesia. PVI value in both groups; After 250ml fluid loading, a statistically significant decrease in T2 compared to T0 was evaluated as fluid 8 responsiveness. In the general anesthesia group, MAP values in the prone position were lower than Group SA. PI values were found to be significantly higher in Group GA compared to Group SA. PVI and PI, which are observed to be sensitive to changes as in general anesthesia, may be recommended to be used in addition to standard hemodynamic monitoring in the management of spinal anesthesia. Keywords: Pleth Variability Index, General Anesthesia, Spinal Anesthesia, Perfusion Index, Prone Position, Lumbar Disc Hernia Surgery