Fifty adult patients undergoing oncosurgery with expected blood loss more than 20% of blood volume were selected. Continuous noninvasive hemoglobin monitoring (SpHb) was done intra-operatively and simultaneous laboratory hemoglobin (LabHb)was sent post-induction, with every 500ml loss and then just before end of surgery. Each patient thus had 3-5 set of paired observations. Paired measurements of SpHb and LabHb were compared using Bland–Altman plot analysis. Blood transfusions were done on the basis of SpHb values. Accuracy to decide on intraoperative blood transfusions were analyzed using three-zone error grids.

We studied 137 paired measurements of laboratory hemoglobin and noninvasive hemoglobin in 50 patients. Correlation of 72.7% (p<0.001) was found between LabHb and SpHb. In Bland Altman analysis the mean bias was -0.38g/dl with 95% of values within the limits of agreement of -2.92 to 2.16 g/dl. Error grid analysis on blood transfusion decision showed 95% of values in Zone A (least error).

The ability to measure hemoglobin noninvasively and continuously has significant potential to facilitate hemoglobin monitoring, hasten the detection of acute anemia, and avoid the complications, expense, and discomfort associated with invasive blood draws. A noninvasive continuous hemoglobin device can be good aide to indicate appropriate blood transfusion. Results of this study show good correlation of SpHb and LabHb. Decision to transfuse, based on SpHb, was accurate 95% of times. The Radical-7® has advantage of providing noninvasive hemoglobin value continuously to take early decision regarding blood transfusion thus avoiding unnecessary blood transfusion and related complications. It can be a worthy device to keep in operation theatre during major oncological surgeries.

Oncological Surgeries, whether palliative or curative, are prolonged surgeries causing huge blood loss, and thus requires massive blood transfusion frequently. Intraoperative blood loss estimation and haemoglobin monitoring thus are necessity for every anaesthesiologist. Laboratory method for haemoglobin estimation is the gold standard technique for this, but as it requires invasive sampling it is quite cumbersome and harbours the risk of needle stick injury. Pulse Co-oximetry by Masimo not only prevents needle stick injury but also-provide real time assessment of intraoperative blood loss in the form of blood levels of haemoglobin. We studied 137 paired measurements of laboratory haemoglobin and spectrophotometric haemoglobin and found a correlation of 72.7% between laboratory haemoglobin and spectrophotometric haemoglobin. For spectrophotometric haemoglobin values less than 11 g/dl correlation was better than spectrophotometric haemoglobin values >11g/dl.