Original Article

Brachial Blood Pressure Monitoring Versus Ankle Monitoring During Colonoscopy

Authors: Jason M. Wilkes, MD, Jack A. DiPalma, MD

Abstract

Objectives: To compare ankle and brachial blood pressure monitoring before and during colonoscopy using automated noninvasive blood pressure (NIBP) monitors.


Methods: Forty-five consecutive patients who presented for outpatient colonoscopy had both ankle and brachial blood pressure monitoring with automated NIBP using an appropriately sized cuff for arm or leg size. Three baseline measurements were obtained, and then measurements were taken at 5-minute intervals during conscious sedation, with brachial blood pressure being the standard.


Results: The average of all of the ankle blood pressures was significantly higher for all systolic and mean arterial blood pressure readings. Diastolic blood pressure readings were higher at baseline, but not significantly different during the procedure.


Conclusions: Ankle systolic and mean arterial blood pressures using automated NIBP monitoring for conscious sedation are significantly higher than brachial blood pressures. Ankle NIBP monitoring should only be used if brachial NIBP monitoring is not feasible, taking into consideration that ankle NIBP pressures are generally higher than brachial.


Key Points


* Ankle systolic and mean arterial blood pressures using automated noninvasive blood pressure (NIBP) monitors are significantly higher than brachial blood pressures.


* Ankle NIBP monitoring should only be used if brachial NIBP monitoring is not feasible.


* Significant hypotension may not be recognized during conscious sedation when ankle NIBP monitoring is used instead of brachial NIBP monitoring.

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