Abstract

Spinal anaesthesia has become the choice of neuraxial anaesthesia for cesarean delivery. Hypotension, the most common side effect of spinal anaesthesia is more in parturients. Perfusion index (PI) is one of the newest methods, used nonivasively for the prediction of hypotension post spinal anaesthesia, evaluation of regional block success, and a tool for pain assessment. In our study we used PI for predicting the occurrence of hypotension post subarachnoid block in elective lower segment cesarean section. Materials and Methods: In this prospect double observational study, 126 parturients were divided into two groups on the basis of baseline PI. Group 1 included parturients with PI of <3.5 and Group 2 parturients with PI value >3.5. Spinal anaesthesia performed was performed with 10mg of Inj.Bupivacaine 0.5% (hyperbaric) at L3-L4 interspace. Hypotension was defined as SBP >20% from baseline. Statistical analysis was performed using Chi-square test and independent sample t-test. Receiver operating characteristic curve (ROC) was plotted for PI and occurrence of hypotension. Results: The incidence of hypotension in Group 1 was 10.5% compared to 71.42% in Group 2 (p<0.001). There was significant correlation between perfusion index >3.5 and number of episodes of hypotension and total dose of ephedrine. The sensitivity and specificity of baseline PI of 3.5 to predict hypotension was 69.84% and 89.29% respectively. Conclusion: Parturients with baseline PI >3.5 are at higher risk of developing hypotension following SAB compared to those with baselin PI ≤3.5.

Description

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