Perfusion index as a predictor of hypotension following subarachnoid block in parturients with non-severe pre-eclampsia undergoing lower segment cesarean section

Abstract

Background and Aims: Perfusion index, which assesses perfusion dynamics is used as a non‑invasive method in spinal anesthesia cases to detect the occurrence of hypotension. A Perfusion Index value after which hypotension is common can be assessed. Methods: In this prospective double-blind observational study, 100 parturients were included. Baseline Perfusion Index was recorded and spinal anesthesia was carried out with Injection bupivacaine 0.5% (hyperbaric), 10 mg at L3 - L4 / L2 - L3 intervertebral space. Fall in Systolic Blood Pressure < 20 % of baseline was defined as hypotension. Chi-Square test and independent sample t-test was used for the statistical analysis. Spearman’s rank correlation coefficient was applied to assess the correlation between baseline PI and hypotension. The receiver operating characteristic (ROC) curve was mapped for PI and the occurrence of hypotension. Results: The occurrence of hypotension in parturients with PI < 4.25 was 40.9% compared to 94.6% in parturients with PI > 4.25. There was a remarkable association between baseline PI > 4.25, the number of episodes of hypotension 53/100 (p-value < 0.0001) and the total dose of phenylephrine used 53/100 (p-value 0.02). T

Perfusion Index and Its Correlation With Intraoperative Hypotension in Lower-Segment Cesarean Section Under Spinal Anesthesia: A Prospective Observational Study in a Tertiary Care Hospital in Eastern India

“…The maternal age and body weight did not have any correlation with the occurrence of post-spinal hypotension in parturients of our study. However, the study conducted by Xu et al [28] showed maternal age, body weight, and BMI in parturients with post-spinal hypotension were higher compared to those who did not have hypotension.…”

“…Regression analysis and ROC curve analysis inferred that a baseline PI cut-off point of 3.5 could be used to recognize parturients vulnerable to hypotension. Likewise, Malavika et al [28] reported a cut-off PI of 4.25 with a sensitivity and specificity of 74.5% and 89.7%, respectively, to detect hypotension in parturients with non-severe pre-eclampsia undergoing LSCS. Xu et al [29] correlated with a high baseline PI of the finger (>3.5) and a low baseline PI of the toe (<2.2) as a predictor of hypotension.…”