Abstract:
BACKGROUND AND AIMS :-
Early detection of hypotension benefits in deciding on preventative measures,
safe anesthesia for the mother, and improved outcomes for the newborn.
Reduced cardiac output from blood pooling in blocked body parts and
decreased vascular resistance from sympathetic blockade cause hypotension
after spinal anesthesia for Caesarean section. Peripheral perfusion dynamics
resulting from variations in peripheral vascular tone have been evaluated using
the perfusion index (PI) obtained from a pulse oximeter.This study aims to
determine whether baseline perfusion index can be used to predict hypotension
following spinal anaesthesia in caesarean section.
METHODS:
In this prospective double blind observational study,140 patients were
enrolled.PI and blood pressure ,heart rate were monitored at baseline.every 3
minutes for first fifteen minutes and then every 5 minutes until the end of
surgery,after
adminstering spinal anaesthesia with 10mg hyperbaric
bupivacaine.Incidence of hypotension was compared with baseline PI.ROC
curve was plotted for PI and prediction of hypotension. RESULTS:-
There was a significant association between baseline PI and hypotension .In our
study , it was observed that the patients with baseline cut off of PI>3.8 the risk
of hypotension was high in first 10-12 minutes following spinal anaesthesia.The
sensitivity and specificity for the 3.8 cut off of PI were 88.6% and 69.2%
respectively.
CONCLUSION:-
Our study found that a baseline PI cut off of 3.8 has higher predictability for
hypotension risk within the first 10-12 minutes following spinal anaesthesia
