Increased fingertip vascular tone leads to a greater fall in blood pressure after induction of general anesthesia

Abstract

General anesthesia causes peripheral vasodilation. We thus hypothesized that patients with increased peripheral vascular tone would become more hypotensive after the induction of general anesthesia compared to those without increased peripheral vascular tone. To test this hypothesis, we compared the decrease in blood pressure after anesthetic induction between patients with increased peripheral vascular tone and those without increased peripheral vascular tone. Twentyseven adult patients (10 men and 17 women) who underwent abdominal surgery with general anesthesia were enrolled in this study. In each patient, the peripheral vascular tone was assessed by either the fingertip skin-surface temperature (FSST) or the forearm-fingertip skin-surface temperature gradient (FFSSTG; forearm skin-surface temperature minus FSST). The decrease in blood pressure 15 min after anesthetic induction was larger in patients with an FSST of 29°C or less (FSST = 27.3 ± 1.6°C; FFSSTG = 5.2 ± 1.6C) than in those with an FSST of more than 29°C (FSST = 30.8 ± 1.0°C; FFSSTG = 1.6 ± 1.2°C). In conclusion, increased fingertip vascular tone (presumably due to thermoregulatory vasoconstriction) before anesthetic induction leads to a greater fall in blood pressure after anesthetic induction.