Efficacy of noninvasive pulse co-oximetry as compared to invasive laboratory-based hemoglobin measurement during spinal anesthesia

Chung, Jin Hun; Ji, Jae Young; Kim, Nan Seol; Seo, Yong Han; Gong, Hyung Youn; Kim, Jae Woo; Kim, Jong Bun; Yoo, Sie Hyeon

Clinical Research

Obstetric Anesthesia

Anesthesia and Pain Medicine 2014;9(4):277-281.
Published online October 31, 2014.

Efficacy of noninvasive pulse co-oximetry as compared to invasive laboratory-based hemoglobin measurement during spinal anesthesia

Jin Hun Chung, Jae Young Ji, Nan Seol Kim, Yong Han Seo, Hyung Youn Gong, Jae Woo Kim, Jong Bun Kim, Sie Hyeon Yoo

¹Department of Anesthesiology and Pain Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. doc0126@dreamwiz.com
²Department of Emergency Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
³Department of Anesthesiology and Pain Medicine, Uijeongbu St Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.

Received: 4 April 2014 • Revised: 11 July 2014 • Accepted: 8 August 2014

Abstract

BACKGROUND
The Masimo Radical 7 (Masimo Corp., Irvine, CA, USA) pulse co-oximeter(R) noninvasively determines the hemoglobin concentration using the principle of transcutaneous spectrophotometry. We compared hemoglobin levels determined using this device (SpHb) with those determined using an invasive laboratory-based technique (tHb) during spinal anesthesia.
METHODS
Thirty patients received spinal anesthesia with 0.5% hyperbaric bupivacaine. The pulse co-oximeter probe was mounted on the second toe, and arterial blood samples were obtained from a radial artery catheter. SpHb, tHb, and perfusion index (PI) values were recorded before and 20 and 40 min after intrathecal injection of bupivacaine.
RESULTS
Before spinal anesthesia, the SpHb and tHb showed a significant difference of -2.86 +/- 1.56 g/dl (P < 0.005), but no significant differences were found between tHb and SpHb at 20 and 40 min after spinal anesthesia (-0.16 +/- 2.45 g/dl and 0.29 +/- 2.68 g/dl). Additionally, PI was significantly increased at 20 and 40 min after spinal anesthesia compared to the pre-anesthetic value (P < 0.001).
CONCLUSIONS
The toe is not the monitoring site for pulse co-oximetry in adult patients, but the pulse co-oximetry on the toe appears to be appropriate as a noninvasive hemoglobin monitoring device after spinal anesthesia.

Key Words: Hemoglobin, Pulse co-oximetry, Spinal anesthesia