Key result
Rapidly increasing perfusion index predicts significant hypotension following spinal anesthesia for cesarean section.
Why the study?
Hypotension is a common complication after spinal anesthesia for cesarean delivery causing adverse outcomes, but standard intermittent non-invasive blood pressure measurement fails to detect episodes in a timely fashion.
Does perfusion index predict hypotension following spinal anesthesia for cesarean section in healthy parturients?
Observational (n=109)
Does perfusion index predict hypotension following spinal anesthesia for cesarean section in healthy parturients?
Perfusion index can serve as a useful early predictor of hypotension following spinal anesthesia for cesarean section, allowing for timely assessment and intervention.
Continuous PI monitoring may enable earlier spinal hypotension detection in cesarean delivery; leaves open impact on outcomes.
Introduction: Hypotension is a common complication after spinal anesthesia for cesarean delivery which is caused by sympathetic block 1. This can result in adverse maternal and fetal outcomes. Hence prevention and early treatment of spinal hypotension early has been a key research area in obstetric anesthesia. Intermittent non-invasive blood pressure measurement is the standard practice that fails to detect episodes of hypotension in a timely fashion. Methods: Noninvasive PI and blood pressure were measured in 109 healthy parturients undergoing elective cesarean section under spinal anesthesia. Results: PI appeared to increase significantly and more quickly in parturients with significant hypotension. Discussion: Findings may be due to the thoracic sympathetic blockade. Conclusion: Perfusion index can be a useful tool to early predict hypotension following spinal anesthesia for cesarean section. Response to ephedrine can be quickly assessed by the change in the PI which helps to decide on further boluses of ephedrine. Effect on the vascular tone by oxytocin is significant with 5IU bolus, though it does not cause a significant blood pressure drop.
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Mallawaarachchi et al. (2020) conducted an observational in Hypotension following spinal anesthesia for cesarean section (n=109). Perfusion index was evaluated on Significant hypotension. Perfusion index increased significantly and more quickly in parturients who developed significant hypotension following spinal anesthesia for cesarean section.
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