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Association between preoperative toe perfusion index and maternal core temperature decrease during cesarean delivery

Shohei Kaneko1,2, Kentaro Hara3,4, Shuntaro Sato5

  • 1Department of Anesthesia, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan. s-kaneko@nagasaki-u.ac.jp.

BMC Anesthesiology
|October 21, 2021
PubMed
Summary

Low preoperative toe perfusion index (PI) predicts core temperature decrease during cesarean delivery under spinal anesthesia. This simple, non-invasive measure aids in early prediction of perioperative hypothermia.

Keywords:
Cesarean deliveryCore temperatureParturientPerioperative hypothermiaSpinal anesthesiaToe perfusion index

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Area of Science:

  • Anesthesiology
  • Obstetrics
  • Physiology

Background:

  • Spinal anesthesia during cesarean delivery causes core body temperature decrease primarily through heat redistribution to the periphery due to vasodilation.
  • Perfusion index (PI) from pulse oximetry reflects peripheral vascular tone and perfusion dynamics.

Purpose of the Study:

  • To investigate if preoperative toe PI can predict intraoperative core temperature decrease in patients undergoing cesarean delivery under spinal anesthesia.

Main Methods:

  • A prospective cohort study involving 48 parturients undergoing cesarean delivery under combined spinal-epidural anesthesia.
  • Continuous toe PI was monitored using a pulse oximeter, and core temperature was recorded.
  • Segmented regression and generalized additive models were used to analyze the association between preoperative toe PI and maximum core temperature decrease.

Main Results:

  • A change in the association between maximum core temperature decrease and preoperative toe PI was observed around PI = 2.4% in the segmented regression model.
  • The generalized additive model indicated a smaller core temperature decrease when preoperative toe PI was above 2.0% to 3.0%.

Conclusions:

  • Low preoperative toe PI is linked to a greater decrease in maternal core temperature during spinal anesthesia for cesarean delivery.
  • Preoperative toe PI serves as a practical, non-invasive tool for early prediction of perioperative hypothermia.