Abstract

It is important to predict and prevent post spinal hypotension in lower segment cesarean section (LSCS). Peripheral vascular tone can be monitored as a perfusion index (PI) from a pulse oximeter. We aimed to study baseline PI as a predictor of post spinal hypotension in LSCS. Material and Methods: Prospective observational study conducted in a tertiary care teaching public hospital on patients posted for elective LSCS under spinal anesthesia. Baseline PI and hypotension were compared. A receiver operating characteristic (ROC) curve was plotted and data were analyzed using SPSS version 20. Results: Baseline PI correlated with the degree of decreases in systolic and mean arterial pressure (r¼0.664, P,0.0001 and r¼0.491, P¼0.0029, respectively). The cut-off PI value of 3.5 identified parturients at risk for spinal anaesthesia-induced hypotension with a sensitivity of 81% and a specificity of 86% (P,0.001). The change of PI in parturients with baseline PI≤3.5 was not significant during the observational period, while PI in parturients with baseline PI.3.5 demonstrated marked decreases after spinal injection. Conclusion: Baseline PI >3.5 was associated with significant post spinal hypotension and vasopressor administration in LSCS. We established baseline PI >2.9 can predict post spinal hypotension with high sensitivity and specificity. PI is simple, quick, and non invasive and can be used as a predictor for post spinal hypotension in parturients undergoing LSCS so that prophylactic measures can be considered in at risk patients for better maternal and fetal outcomes.

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