Perfusion Index Assessed from a Pulse Oximeter as a Predictor of Hypotension during Spinal Anaesthesia for Caesarean Section

Varghese, Dr Regimol V

doi:10.18535/jmscr/v6i5.68

Cited by 5 publications

(7 citation statements)

References 6 publications

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“…[ 16 ] also concluded a significant correlation between PI and the decrease in the systemic arterial pressure, but they had derived a baseline PI of 3.6 as their cutoff value with a sensitivity 80% and specificity of 60%. Varghese[ 17 ] conducted a similar study and concluded the same positive correlation result with an area under the curve of 0.911 and with the same baseline PI of 3.5 having a sensitivity of 86.6% and specificity of 93.33%. A more recent study by Mallawaarachchi et al .…”

Section: Discussionmentioning

confidence: 75%

To study the role of perfusion index as a predictor of hypotension during spinal anesthesia in lower segment cesarean section – A prospective observational study

2021

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Background and Aims: Spinal anesthesia has become the choice of neuraxial anesthesia for cesarean delivery. Hypotension, the most common side effect of spinal anesthesia is more in parturients. Perfusion index (PI) is one of the newest methods, used noninvasively for the prediction of hypotension postspinal anesthesia, evaluation of regional block success, and a tool for pain assessment. In our study, we have used PI for predicting the occurrence of hypotension postsubarachnoid block in elective lower segment cesarean section (LSCS). Methods: In this prospective observational study, parturients posted for elective LSCS under spinal anesthesia were included. Spinal anesthesia was performed at L 3 -L 4 interspace using 25G (gauge) Quincke needle, with 1.8 mL of 0.5% hyperbaric bupivacaine plus 20 μg fentanyl. Hypotension was defined as a decrease in systolic blood pressure >25% from the baseline. Statistical Analysis Used: Statistical analysis was performed using the paired sample t -test, Chi-square test, and independent t -test. Results: From our study, we had found that a positive correlation exists between the baseline PI of the patient and the occurrence of hypotension intraoperatively. A cutoff value of 1.75 (with P < 0.001) was found to be significant; above which the occurrence of hypotension was definite. The sensitivity of this cutoff value was 75% and specificity was 71% for this value. Conclusion: Baseline perfusion of >1.75 can predict hypotension postspinal anesthesia in LSCS. The incidence of hypotension was about 93% in parturients whose baseline was above the cutoff value.

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Section: Discussionmentioning

confidence: 75%

To study the role of perfusion index as a predictor of hypotension during spinal anesthesia in lower segment cesarean section – A prospective observational study

2021

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“…[ 5 ] Varghese RV found that the incidence of hypotension in group 1 (PI >3.5) was 86.67% whereas in group 2 (PI ≤3.5) was 6.67% which was highly significant (p < 0.05). [ 6 ] George et al . found that the incidence of hypotension was 66.7% among the study subjects and they concluded that the incidence and severity of hypotension was higher in parturients with baseline PI >3.6.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] Clinical studies demonstrated that an increase in PI is an early indicator that spinal anesthesia has initiated peripheral vasodilation which typically occurs before the onset of anesthetic effect; however, the literature is limited. [ 5 6 ] Thus, PI can be used as a marker of peripheral perfusion and can be used to assess peripheral perfusion dynamics due to changes in peripheral vascular tone and to detect the likelihood of development of hypotension following spinal anesthesia. Hence, the present study was conducted to evaluate and correlate PI with incidence of hypotension following spinal anesthesia for caesarean section.…”

Section: Introductionmentioning

confidence: 99%

A study to evaluate perfusion index as a predictor of hypotension following spinal anesthesia for caesarean section

Bansal¹,

Lal²,

Bhardwaj³

et al. 2022

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: The perfusion index (PI) has been used as a marker of peripheral perfusion. A lower PI indicates greater peripheral vascular tone and increased risk of hypotension following spinal anesthesia. The present study was conducted to evaluate and correlate perfusion index (PI) with incidence of hypotension following spinal anesthesia for caesarean section. Material and Methods: The present prospective, double blind, observational study included sixty full term parturients in the age group 18-35 years belonging to American Society of Anesthesiologists (ASA) physical status I and II, having singleton pregnancy undergoing caesarean section under spinal anesthesia. On the basis of baseline PI, patients were allocated into one of the two groups: Group I (n = 30) Patients with baseline PI ≤.3.5 and Group II (n = 30) Patients with PI >3.5. Results: The incidence of hypotension in group I was 40% as compared to 73.3% in group II (p = 0.009). Thus, the incidence of hypotension in group II with baseline PI >.3.5 was more as compared to group I. Patients in group II with baseline PI >.3.5 had significantly more episodes of hypotension as compared to those in group I with baseline PI ≤3.5. Conclusion: PI can be used as a useful tool for predicting hypotension in parturients undergoing elective caesarean section under spinal anesthesia in everyday practice.

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“…Dugappa et al found 3.85 as cut-off of baseline PI with sensitivity and specificity of 76% [9] . Varghese et al found 3.83 as a more appropriate cut-off value with a 86.67% sensitivity and 93.33% specificity, positive predictive value of 92.86% and negative predictive value of 87.5% [12] .…”

Section: Discussionmentioning

confidence: 99%

Can a perfusion index, measured by pulse oximeter predict hypotension following spinal anesthesia in healthy parturients undergoing elective lower segment cesarean section?

Shah¹,

Samtani²,

Gautam³

et al. 2021

Int. J. Med. Anesthesiology

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Background: Hypotension is a common complication following spinal anesthesia (SA) for lower segment cesarean section (LSCS) which has detrimental effects both on mother and fetus. This study is aimed at investigating the correlation between baseline perfusion index (PI) and incidence of hypotension following SA for parturients undergoing LSCS. Methods: 60 parturients were divided into two groups of 30 patients each on the basis of baseline PI. Parturients with baseline PI ≤3.5 and >3.5 were added in Group I and Group II respectively. SA was performed with 2ml (10 mg) of injection 0.5% hyperbaric bupivacaine at L3-L4 or L2-L3 inter-space. Hypotension was defined when the mean arterial pressure falls below 65 mmHg which was treated with IV fluid boluses and vasopressors. Results: There was no significant correlation between baseline PI (>3.5 and ≤3.5) and incidence and severity of hypotension (p > 0.05). Conclusion:Parturients with baseline PI > 3.5 were not at higher risk of developing hypotension following spinal anesthesia compared to those with baseline PI ≤ 3.5.

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Perfusion Index Assessed from a Pulse Oximeter as a Predictor of Hypotension during Spinal Anaesthesia for Caesarean Section

Abstract: Background and Aims: Hypotension during spinal anaesthesia for caesarean section is a common and important problem with foetal and maternal implications. Perfusion Index (PI) observes from a pulse

Cited by 5 publications

References 6 publications

To study the role of perfusion index as a predictor of hypotension during spinal anesthesia in lower segment cesarean section – A prospective observational study

To study the role of perfusion index as a predictor of hypotension during spinal anesthesia in lower segment cesarean section – A prospective observational study

A study to evaluate perfusion index as a predictor of hypotension following spinal anesthesia for caesarean section

Can a perfusion index, measured by pulse oximeter predict hypotension following spinal anesthesia in healthy parturients undergoing elective lower segment cesarean section?

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