The Role of Peripheral Volume Pulse in Cardiovascular Monitoring during Anaesthesia

Abstract

German

French

Compared to ECG, peripheral volume pulse (PVP) is both far more sensitive and provides more important information as to circulation. In addition it is free of electrical hazards and disturbances, being both noninvasive and atraumatic. It can be applied either with conventional leads or by telemetry, and is useful in all operative positions and sites. The only possible danger is pressure necrosis and burns of the ear lobe due to overextended use of transmission type photoelectric plethysmographic monitoring with a too tightly screwed photocell. For routine patient monitoring during anaesthesia, PVP together with BP and CVP provide all the necessary information. The photoelectric, plethysmographic and piezoelectric transducers all monitor alpha-receptor activity but only the last-mentioned, when placed on striated muscle, will show changes in beta-activity. The plethysmographic method gives detailed information on volume/pressure changes in the periphery, also is useful in analyzing circulation time and left ventricular performance. Moreover PVP is extremely sensitive to changes in depth of anaesthesia.

Keywords

peripheral volume pulse anaesthesia monitoring arrhythmia sympathetic activity transducers pain volume replacement

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References

Beene

T.K.

and Eggers, Jr., G.W.N.: Use of the pulse monitor for determining sympathetic block of the arm. Anesthesiology Vol. 40, 412–414, 1974.

Cooper

Skillman

J.J.

Ciampa

G.R.

and Edwards

E.A

.: External pulse recording in experimental hemorrhage and drug infusion in man. Surq Gynecol. Obstet. Vol. 125, 1246–1252, 1967.

Ejrup

Ertama

Mattila

Kumlin

and Rybeck

: Pulse curve registration from the big toe during reactive hyperaemia in arterial circulation disorders of the lower extremities. J. Cardio-vascular Surq. (Torino) Vol. 7, 275–282, 1966.

Horiguti

: The removal of the disorders of the autonomic nervous system. Acupuncture and Electro-Therapeut. Res. Int, J. Vol. 4, 105–136, 1979.

Johnstone

: The effects of oral sedatives on the vasoconstrictive reaction to fear. Br. J. Anaesthesia Vol. 43, 380–384, 1971.

Johnstone

: The cardiovascular effects of oxytocic drugs. Br. J. Anaesthesia Vol. 44, 826–834, 1972.

Johnstone

: Digital vasodilatation: A sign of anaesthesia. Br. J. Anaesthesia Vol. 46, 414–419, 1974.

Johnstone

: Facial vasomotor behaviour. Br. J. Anaesthesia, Vol. 46. 765–769, 1974.

Johnstone

: The effect of lorazepam on the vasoconstriction of fear. Anaesthesia Vol. 31, 863–872, 1976.

10.

Johnstone

: The cardiovascular effects of ketamine in man. Anaesthesia Vol. 31, 873–882, 1976.

11.

Johnstone

and Barron

P.T

.: The cardiovascular effects of pro-panidid. Anaesthesia Vol. 23, 180–193, 1968.

12.

Johnstone

and Horsfall

G.B

.: Propranolol (Inderal) and the per-ipheral blood flow during halothane anaesthesia. Acta Anaesth. Scan- dinavica Suppl. 23, 248–254, 1966.

13.

Omura

and Lee

: Applications of ultraminature photoelectric plethysmographic sensors with a very short response time to the non- traumatic study of the circulatory system. Transactions of the American Society for Artificial Internal Organs Vol. 17, 392–404, 1971.

14.

Omura

Pathophysiology of acupuncture treatment: Effects of acu-puncture on cardiovascular and nervous systems. Acupuncture & Electro- Therapeut. Res. Int. J. Vol. 1, 51–141, 1975.

15.

Omura

: The effects of acupuncture on the cardiovascular and nervous systems, with special emphasis on clinical applications of acupuncture- induced vasodilatation and accompanying blood chemistry changes, in-cluding release of ACTH and endorphins. Paper presented at the National Symposia on Acupuncture and Moxibustion and Acupuncture Anaesthesia, Beijing, June lst-5th 1979.

16.

Pontinen

P.J

.: Cardiovascular effects of local adrenaline infiltration during halothane anaesthesia and adrenergic beta-receptor blockade in man. Acta Anaesth. Scandinavica Vol. 22, 130–144, 1978.

17.

Pontinen

P.J

.: Cardiovascular effects of local adrenaline infiltration during neuroleptanalgesia and adrenergic beta-receptor blockade in man. Acta Anaesth. Scandinavica Vol. 22, 145–153, 1978.