HOW CAN ANESTHESIOLOGIST USE THE PERFUSION INDEX IN ENDOSCOPIC RHINOSINUS SURGERY.
The perfusion index is an additional diagnostic tool that allows you to objectify the condition of peripheral blood flow, which determines the intensity of local bleeding during endoscopic rhinosinus surgery. Objective - to evaluate the possibility of using the perfusion index to optimize anesthesia in endoscopic rhinosinus surgery. Materials and methods - publications from scientific Russian and international databases. The search was performed by keywords. The perfusion index is characterized by a pronounced asymmetry, mainly in patients who are in critical condition and / or have other severe pathological conditions (heart failure, hypovolemia, hypothermia), which can have a significant effect on the perfusion of peripheral tissues. The perfusion index is an accurate tool for assessing changes in peripheral perfusion during general anesthesia in hemodynamically stable patients. Controlled hypotension is applied by increasing the concentration of inhalation anesthetic or introducing additional increased dosages of narcotic analgesics in order to reduce the intensity of intraoperative bleeding. However, this technique leads to the development of peripheral vasoplegia and an increase in diffuse soft tissue bleeding in addition to lowering blood pressure. Intraoperative target management of the perfusion index allows maintaining a sufficient level of anesthesia without the need for a significant decrease in mean arterial pressure, which increases the safety of surgical intervention. It is possible to use terlipressin for intraoperative maintenance of the perfusion index in normal values. Targeted management of peripheral perfusion allows optimizing the performance of endoscopic rhinosinus surgery under general anesthesia.