Efficacy of Goal-Directed Fluid Therapy Guided by Pleth Variability Index in Patients Undergoing Large Volume Liposuction Under General Anesthesia

Document Type : Original Article

Authors

1 Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

2 Department of Anesthesia, Intensive Care and Pain Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Background: Liposuction, which was introduced in the early 1980s, has undergone major developments and is now the most widely done aesthetic surgery.
Aim of the work: This study aimed to assess efficiency of pleth variability index [PVI] obtained from Massimo pulse oximeter to anticipate intraoperative responsiveness of fluid in large volume liposuction under general anesthesia.
Patients and methods: This prospective comparative randomized controlled trial, 60 females undergoing liposuction 5 liters or more, aged range 21-40 years, patients grouped according to fluid management strategy, thirty cases were managed by Rohrich formula [control group] and thirty were managed by PVI [study group].
Results: There was statistically significant difference as regards total IV fluid with mean 2790 [SD = 443] in control versus 3155 [SD = 452] in PVI group as well as urinary output mean 1410 [SD = 382] in control versus 2019 [SD = 449] in PVI group. Significant postoperative lactate [mean 2.5 [SD = 1.1] in control versus 0.9 [SD = 1] in PVI group]. No significant difference in hypotensive episodes [mean 0.77 [SD = 1.01] recorded from 11/30 patients developed hypotension in control versus 1.07 [SD = 1.20] from 12/30 patients in PVI group]. Insignificant postoperative readiness for discharge [mean 3.9 [SD = 0.8] in control versus 4.07 [SD = 0.87] in PVI group].
Conclusion: Fluid administration guided by PVI resulted in increased intraoperative fluid with better peripheral tissue perfusion compared to Rohrich formula. But Rohrich is still valid and can be used safely with caution as a patient might be under-hydrated.

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