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Journal of Medical and Biological Engineering

, Volume 37, Issue 6, pp 820–825 | Cite as

Alteration of Arterial Mechanical Impedance Greater than that of Photoplethysmogram and Laser Doppler Flowmetry during Endoscopic Thoracic Sympathectomy

  • Sukhdorj Elbegzaya
  • Ryuji Nakamura
  • Noboru Saeki
  • Kensuke Yanabe
  • Abdugheni Kutluk
  • Hiroki Hirano
  • Harutoyo Hirano
  • Toshio Tsuji
  • Masashi Kawamoto
Original Article

Abstract

Blood flow monitoring systems such as photoplethysmogram (PPG) and laser Doppler flowmetry (LDF) are useful for intraoperative determination of a successful endoscopic thoracic sympathectomy (ETS) procedure, as they are able to indicate a sympatholytic response. A recently developed novel arterial mechanical impedance monitor has been shown able to provide a value for peripheral arterial stiffness, shown as K. In this retrospective cohort study, we compared the intensity of K with that of PPG and LDF during ETS procedures. Seventy-nine patients with hyperhidrosis underwent a surgical sympathectomy procedure under general anesthesia, during which they were managed by monitors attached to the tips of their fingers. Circulatory variables before and after the surgical procedure were recorded during ETS, then the ratios of those indices were statistically compared. With a statistical significance level of p < 0.05, K was shown to have a greater alteration as compared to PPG and LDF at the time of skin incision as well as neural clipping in both hands. We concluded that arterial mechanical impedance shown by K is a more sensitive monitor of sympathetic activity derived from vasoconstriction and vasodilation during an ETS procedure as compared to PPG and LDF.

Keywords

Photoplethysmography Autonomic response Depth of anesthesia Arterial mechanical impedance 

References

  1. 1.
    Drott, C., Gothberg, G., & Claes, G. (1995). Endoscopic transthoracic sympathectomy: An efficient and safe method for the treatment of hyperhidrosis. Journal of the American Academy of Dermatology, 33(1), 78–81.CrossRefGoogle Scholar
  2. 2.
    Luginbuhl, M., Reichlin, F., Sigurdsson, G. H., Zbinden, A. M., & Petersen-Felix, S. (2002). Prediction of the haemodynamic response to tracheal intubation: Comparison of laser-Doppler skin vasomotor reflex and pulse wave reflex. British Journal of Anaesthesia, 89(3), 389–397.CrossRefGoogle Scholar
  3. 3.
    Ginosar, Y., Weiniger, C. F., Meroz, Y., Kurz, V., Bdolah-Abram, T., Babchenko, A., et al. (2009). Pulse oximeter perfusion index as an early indicator of sympathectomy after epidural anesthesia. Acta Anaesthesiologica Scandinavica, 53(8), 1018–1026. doi: 10.1111/j.1399-6576.2009.01968.x.CrossRefGoogle Scholar
  4. 4.
    Kim, J. M., Arakawa, K., & VonLintel, T. (1975). Use of the pulse-wave monitor as a measurement of diagnostic sympathetic block and of surgical sympathectomy. Anesthesia and Analgesia, 54(3), 289–296.CrossRefGoogle Scholar
  5. 5.
    Eisenach, J. H., Pike, T. L., Wick, D. E., Dietz, N. M., Fealey, R. D., Atkinson, J. L. D., et al. (2005). A comparison of peripheral skin blood flow and temperature during endoscopic thoracic sympathotomy. Anesthesia and Analgesia, 100(1), 269–276. doi: 10.1213/01.ANE.0000139934.15659.7F.CrossRefGoogle Scholar
  6. 6.
    Murray, W. B., & Foster, P. A. (1996). The peripheral pulse wave: information overlooked. Journal of Clinical Monitoring, 12(5), 365–377.CrossRefGoogle Scholar
  7. 7.
    Nakamura, R., Saeki, N., Kutluk, A., Shiba, K., Tsuji, T., Hamada, H., et al. (2009). Arterial mechanical impedance is a sensitive stress response monitor during general anesthesia. Hiroshima Journal of Medical Sciences, 58(4), 75–82.Google Scholar
  8. 8.
    Kutluk, A., Tsuji, T., Ukawa, T., Nakamura, R., Saeki, N., Yoshizumi, M., et al. (2010). A novel online method to monitor autonomic nervous activity based on arterial wall impedance and heart rate variability. Medical & Biological Engineering & Computing, 48(4), 351–359. doi: 10.1007/s11517-010-0580-7.CrossRefGoogle Scholar
  9. 9.
    Hirano, H., Horiuchi, T., Kurita, Y., Ukawa, T., Nakamura, R., Saeki, N., Yoshizumi, M., Kawamoto, M., & Tsuji, T. (2013). Monitoring of peripheral vascular condition using a log-linearized arterial viscoelastic index during endoscopic thoracic sympathectomy. Conf Proc IEEE Eng Med Biol Soc, 2587–2590, doi: 10.1109/EMBC.2013.6610069.
  10. 10.
    Bland, J. M., & Altman, D. G. (1995). Multiple significance tests: The Bonferroni method. BMJ, 310(6973), 170.CrossRefGoogle Scholar

Copyright information

© Taiwanese Society of Biomedical Engineering 2017

Authors and Affiliations

  1. 1.Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
  2. 2.College of Medical Engineering TechnologyXinjiang Medical UniversityUrumqiChina
  3. 3.Graduate School of EngineeringHiroshima UniversityHigashi-HiroshimaJapan
  4. 4.College of EngineeringShizuoka UniversityShizuokaJapan

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