Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study
Jingwei Xiong, Miaomiao Xu, Kangli Hui, Jiejie Zhou, Jie Zhang, Manlin Duan, Lidong Zhang- Biochemistry (medical)
- Cell Biology
- Biochemistry
- General Medicine
Objective
To test agreement and interchangeability between distal (dRA) and forearm radial arterial (RA) pressures (AP) during general anesthesia (GA) for prone spinal surgery.
Methods
This prospective observational study involved 40 patients scheduled for GA spinal surgery. The right dRA and left forearm RA were cannulated in all patients to continuously measure invasive blood pressures (IBP). We compared the agreement and trending ability of systolic AP (SAP), diastolic AP (DAP), and mean AP (MAP) at each site 15 minutes after tracheal intubation, start of surgery, 30 and 60 minutes after the start of surgery, and after skin suturing.
Results
Paired BP values (n = 184) (37 cases) were analyzed. The bias (standard deviation), limits of agreement, and percentage error were: SAP: 0.19 (3.03), −5.75 to 6.12, and 5.04%; DAP: −0.06 (1.75), −3.50 to 3.38, and 5.10%; and MAP: 0.08 (1.52), −2.90 to 3.05, and 3.54%, respectively. The linear regression coefficients of determination were 0.981, 0.982, and 0.988 for SAPs, DAPs, and MAPs, respectively; four-quadrant plot concordance rates were 95.11%, 92.03%, and 92.66%, respectively.
Conclusion
All arterial BPs showed good agreement and trending capabilities for both the dRA and RA. The dRA may be substituted for the RA in IBP monitoring.