Perfusion Index Measurement Can not Predict Hypotension During Procedural Sedation in Hypertensive Patients Undergoing Colonoscopy

Background Hypotension is frequently encountered during colonoscopy performed under propofol sedation. Patients with chronic hypertension often exhibit baroreceptor desensitisation, reduced vascular compliance, or intravascular volume depletion due to diuretic therapy. The perfusion index (PI), derived from photoplethysmographic signals, reflects beat-to-beat changes in blood volume. This study aimed to evaluate whether perioperative PI measurements can predict propofol-related hypotension during procedural sedation in patients with chronic hypertension. Methods This prospective study included 125 patients with chronic hypertension scheduled to undergo colonoscopy under propofol sedation. Perfusion index and blood pressure measurements were recorded preoperatively, at 3-minute intervals during the first 10 minutes following induction, and subsequently at 5-minute intervals. The association between PI values and the development of hypotension was analysed. Results Hypotension occurred in 28 patients (22.7%). Preoperative PI values did not differ significantly between patients who developed hypotension and those who did not (p = 0.417). Similarly, no significant association was found between hypotension and the PI-measurement/PI-baseline ratio (p > 0.05). Conclusion In this cohort of hypertensive patients undergoing procedural sedation with propofol, finger-derived perfusion index values were not effective in predicting the development of hypotension.