• J F Heusdens, S Lof, C W A Pennekamp, J C Specken-Welleweerd, G J de Borst, W A van Klei, L van Wolfswinkel, and R V Immink.
• Department of Anaesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
• Br J Anaesth. 2016 Sep 1; 117 (3): 316-23.

BackgroundPatients undergoing carotid endarterectomy require strict arterial blood pressure (BP) control to maintain adequate cerebral perfusion. In this study we tested whether non-invasive beat-to-beat Nexfin finger BP (BPfin) can replace invasive beat-to-beat radial artery BP (BPrad) in this setting.MethodsIn 25 consecutive patients (median age 71 yr) scheduled for carotid endarterectomy and receiving general anaesthesia, BPfin and BPrad were monitored simultaneously and ipsilaterally during the 30-min period surrounding carotid artery cross-clamping. Validation was guided by the standard set by the Association for the Advancement of Medical Instrumentation (AAMI), which considers a BP monitor adequate when bias (precision) is <5 (8) mm Hg, respectively.ResultsBPfin vs BPrad bias (precision) was -3.3 (10.8), 6.1 (5.7) and 3.5 (5.2) mm Hg for systolic, diastolic, and mean BP, respectively. One subject was excluded due to a poor quality BP curve. In another subject, mean BPfin overestimated mean BPrad by 13.5 mm Hg.ConclusionMean BPfin could be considered as an alternative for mean BPrad during a carotid endarterectomy, based on the AAMI criteria. In 23 of 24 patients, the use of mean BPfin would not lead to decisions to adjust mean BPrad values outside the predefined BP threshold.ClinicaltrialsgovNCT01451294.© The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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