Author(s)

Kunal Tewari¹, Vibhu Raghuvanshi², Deepak Mishra³, Nitin Pahuja³, Maj Jyotsna³, Om Bahadur Thapa³

¹Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, India.
²Chauhan Medicity and Trauma Centre, Pathankot, India.
³Department of Anaesthesiology and Critical Care, Command Hospital (Southern Command), Pune, India.

Background and Aims: Pulse pressure variation (PPV) is a reliable and predictive dynamic parameter presently being utilized for fluid responsiveness. In the operating room, fluid administration based on PPV monitoring helps the physician in deciding whether to volume resuscitate or use interventions in patients undergoing surgery. Propofol is an intravenous induction agent which lowers blood pressure. There are multiple causes such as depression in cardiac output, and peripheral vasodilatation for hypotension. We undertook this study to observe the utility of PPV as a guide to fluid therapy after propofol induction. Primary outcome of our study was to monitor PPV as a marker of fluid responsiveness for the hypotension caused by propofol induction. Secondary outcome included the correlation of PPV with other hemodynamic parameters like heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP); after induction with propofol at regular interval of time. Methods: A total number of 90 patients were recruited. Either of the radial artery was then cannulated under local anaesthesia with 20G VygonLeadercath arterial cannula and invasive monitoring transduced. A baseline recording of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and PPV was then recorded. Patients were then induced with predetermined doses of propofol (2 mg/kg) and recordings of HR, SBP, DBP, and PPV were taken at 5, 10 and 15 minutes. Results: Intraoperatively, PPV was significantly higher at 5 minutes and significantly lower at 15 minutes after induction. It was observed that there were no statistically significant correlations between PPV and SBP or DBP. PPV was strongly and directly associated with HR. Conclusion: We were able to establish that PPV predicts fluid responsiveness in hypotension caused by propofol induction; and can be used to administer fluid therapy in managing such hypotension. However, PPV was not directly correlated with hypotension subsequent to propofol administration.

Pulse Pressure Variation (PPV), Propofol, Fluid Responsiveness

Tewari, K. , Raghuvanshi, V. , Mishra, D. , Pahuja, N. , Jyotsna, M. and Thapa, O. (2024) A Study to Observe Pulse Pressure Variation after Induction with Propofol for General Anesthesia. World Journal of Cardiovascular Diseases, 14, 343-350. doi: 10.4236/wjcd.2024.145028.