Increase in pulse transit time to the foot after epidural anaesthesia treatment

A. Babchenko, E. Davidson, D. Adler, Y. Ginosar, V. Kurz, M. Nitzan

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Epidurally induced anaesthetic treatment is a routine treatment for pain relief during surgical procedure, based on blocking the sensory and sympathetic fibres that mediate pain. The epidural sympathetic block results in relaxation of the muscle walls in the lower limbs, which can be assessed by the resultant haemodynamic changes. In the current study, the difference tt,f in the transit time of the blood pressure pulses between the toe and the finger is measured by photoplethysmography (PPG). Fifteen patients are administered 10 ml 0.25% of bupivacaine, ten patients are administered 10 ml 0.5%, and 17 patients are administered 40 ml 0.0625%. tt,f decreases as a function of the patient's age and blood pressure, both before and after the sympathetic block, owing to the decrease in arterial compliance with age and blood pressure. The time delay tt,f increases after the epidural treatment by 10.1±7.0 and by 16.8±10.8 ms for the 0.25% and the 0.5% concentrations, respectively. The time delay increase for the lowest concentration is not statistically significant. The toe-finger time delay change is found to reflect the haemodynamic changes induced by the sympathetic block with higher reliability than the routine methods of skin temperature or arterial blood pressure.

Original languageEnglish
Pages (from-to)674-679
Number of pages6
JournalMedical and Biological Engineering and Computing
Issue number6
StatePublished - 2000
Externally publishedYes


  • Arterial compliance
  • Epidural anaesthesia
  • Photoplethysmography
  • Pulse transit time


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