Perfusion Index Derived from a Pulse Oximeter can Predict the Incidence of Hypotension During Spinal Anesthesia for Cesarean Delivery

Toyama, Satoshi; Kakumoto, Masaya; Morioka, Masayo; Matsuoka, K.; Omatsu, H.; Tagaito, Yugo; Numai, Takeshi; Shimoyama, Megumi

doi:10.1097/01.aoa.0000452200.08393.66

Cited by 3 publications

(7 citation statements)

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“…While in the study conducted by Dugappa et al the sensitivity and specificity of cut-off value of baseline PI of 3.5 was 89.29% and 69.84% respectively. [9] Similarly the ~ 184 ~ sensitivity and specificity of cut-off value of baseline PI of 3.5 in a study conducted by Toyama et al was 81% and 86% respectively [8] .…”

Section: Discussionmentioning

confidence: 92%

“…Ginosar et al in their study showed that increase in PI following epidural anesthesia was clear indicator of sympathectomy [5] . The cut-off value of baseline perfusion index for predicting hypotension following SA was taken as 3.5 based on a study done by Toyama et al [8] and Dugappa et al [9] and from their studies it was concluded that cut-off point of baseline perfusion index of 3.5 can be used to identify parturients at risk for such hypotension. We attempted to study the predictive ability of this value in our study.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 92%

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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“…051-077/078). An estimated sample size of minimum 116 patients in each group was calculated based on 81% sensitivity as per Toyama et al 6 within 95% confidence interval and a 7% margin of error. Informed written consent was obtained from all the participants.…”

Section: Methodsmentioning

confidence: 99%

“…5 There are studies that have used PI to detect the likelihood of spinal anesthesia associated hypotension. Toyama et al 6 and Duggappa et al 7 studied PI as a predictor of hypotension in parturients undergoing cesarean section under spinal anesthesia. They found a PI value of 3.5 as a cutoff point to predict hypotension in their population.…”

Section: Introductionmentioning

confidence: 99%

The Usefulness of Perfusion Index Derived from a Pulse Oximeter in Predicting Hypotension following Spinal Anesthesia for Cesarean Section

et al. 2022

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Hypotension is a frequent complication of spinal anesthesia. Decrease in peripheral vascular tone that occurs during pregnancy is one of the factors causing hypotension in patients undergoing cesarean section under spinal anesthesia. Perfusion index derived from pulse oximeter can be an easy and non-invasive measure of peripheral perfusion. This study was conducted to test the usefulness of pulse oximeter in predicting hypotension following spinal anesthesia for cesarean section. In this study, 247 parturients undergoing elective cesarean section under spinal anesthesia were included. Parturients who had baseline PI<3.5 were kept in Group I and parturients who had baseline PI>3.5 were kept in Group II. All the patients were given 0.5% bupivacaine heavy 2.2 ml for spinal anesthesia. In group I, 30 patients (23.62%) had hypotension whereas in Group II, 119 patients (100%) had hypotension. The episodes of hypotension were significantly lower in Group I as compared to Group II (p<0.001). The dose of mephentermine (p<0.001) used was also significantly lower in Group I as compared to Group II. Therefore, we concluded that a baseline PI>3.5 is a prediction of hypotension following spinal anesthesia in patients undergoing cesarean section.

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“…One of these was the use of a perfusion index derived from a pulse oximeter which effectively assesses peripheral perfusion dynamics and vascular tone, and which has been shown to predict spinal hypotension. 34 More studies are required to determine the place of this monitor in routine clinical practice.…”

Section: Other Predictorsmentioning

confidence: 99%

Predicting spinal hypotension during Caesarean section

Bishop

2014

Southern African Journal of Anaesthesia and Analgesia

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Hypotension under spinal anaesthesia for Caesarean section remains a common problem, with attendant maternal and foetal morbidity. This review examines some of the issues surrounding the prediction of spinal hypotension, including concerns about current evidence, the debate on the mechanism of hypotension and the utility of prediction in this group of patients. It then covers some of the more conventional and established preoperative predictors of hypotension. Particular attention is paid to the assessment of autonomic function and some of the novel methods being used as predictors of severe maternal hypotension. The implications of autonomic dysfunction and areas for future research are discussed.

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Perfusion Index Derived from a Pulse Oximeter can Predict the Incidence of Hypotension During Spinal Anesthesia for Cesarean Delivery

Cited by 3 publications

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

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

The Usefulness of Perfusion Index Derived from a Pulse Oximeter in Predicting Hypotension following Spinal Anesthesia for Cesarean Section

Predicting spinal hypotension during Caesarean section

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