Pulse oximeter perfusion index as a new predictor of hypotension following subarachnoid block in lower segment Cesarean section: A prospective randomized study
Background: Hypotension is a common adverse effect of spinal anesthesia, especially during pregnancy, due to the blockade of pre-ganglionic sympathetic fibers, resulting in reduced peripheral vascular resistance. This study explores the perfusion index (PI) as a potential predictor for hypotension d...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Manipal College of Medical Sciences, Pokhara
2025-02-01
|
| Series: | Asian Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://ajmsjournal.info/index.php/AJMS/article/view/4395 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832575416888459264 |
|---|---|
| author | Ashish Mohan M Suman Gupta Kavya Kanjikkal Vankudoth Bhaskar |
| author_facet | Ashish Mohan M Suman Gupta Kavya Kanjikkal Vankudoth Bhaskar |
| author_sort | Ashish Mohan M |
| collection | DOAJ |
| description | Background: Hypotension is a common adverse effect of spinal anesthesia, especially during pregnancy, due to the blockade of pre-ganglionic sympathetic fibers, resulting in reduced peripheral vascular resistance. This study explores the perfusion index (PI) as a potential predictor for hypotension during spinal anesthesia in lower segment Cesarean sections (LSCS).
Aims and Objectives: The aim of the study was to study the correlation between baseline PI and the incidence of hypotension following subarachnoid block in LSCS.
Materials and Methods: This prospective observational study included 90 parturients, divided into two groups based on baseline PI: Group 1 (PI≤3.5) and Group 2 (PI>3.5). Spinal anesthesia was administered with 10 mg of 0.5% hyperbaric bupivacaine at the L3-L4 interspace. The study evaluated the correlation between baseline PI and the degree of hypotension, as well as PI’s predictive capacity for hypotension during Cesarean delivery.
Results: Hypotension occurred in 35.55% of Group 1 and 75.55% of Group 2 (P<0.001). A significant correlation was found between baseline PI>3.5 and both the incidence of hypotension and the total mephentermine dose required (P<0.001). The sensitivity and specificity of PI>3.5 for predicting hypotension were 68% and 72.5%, respectively. The area under the receiver operating characteristic curve for PI as a predictor of hypotension was 0.914.
Conclusion: A higher baseline PI is associated with a higher incidence and severity of hypotension following spinal anesthesia. Baseline PI is a reliable predictor of spinal anesthesia-induced hypotension during Cesarean delivery and could be used for early identification and management of at-risk patients. |
| format | Article |
| id | doaj-art-35513fa341954460b891e77ddcf61fee |
| institution | Kabale University |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-35513fa341954460b891e77ddcf61fee2025-02-01T08:11:19ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-02-011623137https://doi.org/10.71152/ajms.v16i2.4395Pulse oximeter perfusion index as a new predictor of hypotension following subarachnoid block in lower segment Cesarean section: A prospective randomized studyAshish Mohan M 0https://orcid.org/0009-0004-7660-1141Suman Gupta 1https://orcid.org/0000-0003-2205-8353Kavya Kanjikkal 2https://orcid.org/0009-0002-8582-5476Vankudoth Bhaskar 3https://orcid.org/0009-0006-8387-9998Postgraduate Resident, Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India Professor, Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India Postgraduate Resident, Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India Postgraduate Resident, Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India Background: Hypotension is a common adverse effect of spinal anesthesia, especially during pregnancy, due to the blockade of pre-ganglionic sympathetic fibers, resulting in reduced peripheral vascular resistance. This study explores the perfusion index (PI) as a potential predictor for hypotension during spinal anesthesia in lower segment Cesarean sections (LSCS). Aims and Objectives: The aim of the study was to study the correlation between baseline PI and the incidence of hypotension following subarachnoid block in LSCS. Materials and Methods: This prospective observational study included 90 parturients, divided into two groups based on baseline PI: Group 1 (PI≤3.5) and Group 2 (PI>3.5). Spinal anesthesia was administered with 10 mg of 0.5% hyperbaric bupivacaine at the L3-L4 interspace. The study evaluated the correlation between baseline PI and the degree of hypotension, as well as PI’s predictive capacity for hypotension during Cesarean delivery. Results: Hypotension occurred in 35.55% of Group 1 and 75.55% of Group 2 (P<0.001). A significant correlation was found between baseline PI>3.5 and both the incidence of hypotension and the total mephentermine dose required (P<0.001). The sensitivity and specificity of PI>3.5 for predicting hypotension were 68% and 72.5%, respectively. The area under the receiver operating characteristic curve for PI as a predictor of hypotension was 0.914. Conclusion: A higher baseline PI is associated with a higher incidence and severity of hypotension following spinal anesthesia. Baseline PI is a reliable predictor of spinal anesthesia-induced hypotension during Cesarean delivery and could be used for early identification and management of at-risk patients.https://ajmsjournal.info/index.php/AJMS/article/view/4395pregnancy; spinal anesthesia; subarachnoid; hyperbaric; hypotension; perfusion index |
| spellingShingle | Ashish Mohan M Suman Gupta Kavya Kanjikkal Vankudoth Bhaskar Pulse oximeter perfusion index as a new predictor of hypotension following subarachnoid block in lower segment Cesarean section: A prospective randomized study Asian Journal of Medical Sciences pregnancy; spinal anesthesia; subarachnoid; hyperbaric; hypotension; perfusion index |
| title | Pulse oximeter perfusion index as a new predictor of hypotension following subarachnoid block in lower segment Cesarean section: A prospective randomized study |
| title_full | Pulse oximeter perfusion index as a new predictor of hypotension following subarachnoid block in lower segment Cesarean section: A prospective randomized study |
| title_fullStr | Pulse oximeter perfusion index as a new predictor of hypotension following subarachnoid block in lower segment Cesarean section: A prospective randomized study |
| title_full_unstemmed | Pulse oximeter perfusion index as a new predictor of hypotension following subarachnoid block in lower segment Cesarean section: A prospective randomized study |
| title_short | Pulse oximeter perfusion index as a new predictor of hypotension following subarachnoid block in lower segment Cesarean section: A prospective randomized study |
| title_sort | pulse oximeter perfusion index as a new predictor of hypotension following subarachnoid block in lower segment cesarean section a prospective randomized study |
| topic | pregnancy; spinal anesthesia; subarachnoid; hyperbaric; hypotension; perfusion index |
| url | https://ajmsjournal.info/index.php/AJMS/article/view/4395 |
| work_keys_str_mv | AT ashishmohanm pulseoximeterperfusionindexasanewpredictorofhypotensionfollowingsubarachnoidblockinlowersegmentcesareansectionaprospectiverandomizedstudy AT sumangupta pulseoximeterperfusionindexasanewpredictorofhypotensionfollowingsubarachnoidblockinlowersegmentcesareansectionaprospectiverandomizedstudy AT kavyakanjikkal pulseoximeterperfusionindexasanewpredictorofhypotensionfollowingsubarachnoidblockinlowersegmentcesareansectionaprospectiverandomizedstudy AT vankudothbhaskar pulseoximeterperfusionindexasanewpredictorofhypotensionfollowingsubarachnoidblockinlowersegmentcesareansectionaprospectiverandomizedstudy |