Perfusion index to predict post spinal hypotension in lower segment caesarean section

Area of Science:

• Anesthesiology
• Obstetrics
• Critical Care Medicine

Background:

• Post-spinal hypotension is a significant concern during lower segment cesarean section (LSCS).
• Monitoring peripheral vascular tone via perfusion index (PI) from a pulse oximeter offers a potential predictive method.

Purpose of the Study:

• To evaluate baseline perfusion index (PI) as a predictor of post-spinal hypotension in patients undergoing LSCS.

Main Methods:

• A prospective observational study was conducted on 90 patients undergoing elective LSCS under spinal anesthesia.
• Baseline PI was measured and compared with the incidence of hypotension.
• Receiver operating characteristic (ROC) curve analysis was used to determine predictive accuracy.

Main Results:

• A baseline PI > 3.5 was significantly associated with post-spinal hypotension (97.9%) and vasopressor requirement (61.7%).
• ROC analysis demonstrated that a baseline PI > 2.9 is an excellent classifier for hypotension (AUC = 0.917).
• The predictive model achieved high sensitivity (83.08%) and specificity (96.00%) for hypotension.

Conclusions:

• Baseline PI is a simple, non-invasive, and effective predictor of post-spinal hypotension in LSCS.
• Utilizing baseline PI can guide prophylactic measures in at-risk parturients, potentially improving maternal and fetal outcomes.