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Volume 12 Issue 3 ( July-September ) 2023

Original Articles

Prediction Of Hypotension Following Spinal Anaesthesia For Caesarean Delivery Using Perfusion Index
Dr. Mithun Mohan, Dr .Neeraj Narang, Dr. Kamalraj Singh Baghel, Dr. Pradyumna Singh Kakodia, Dr. Nishitha Diwakar, Dr. Shivank Sethi

Aim: To evaluate use of baseline perfusion index for prediction of hypotension following spinal anaesthesia for caesarean section. Objectives: Primary Objective- To find out whether baseline perfusion index has any relation in the occurrence of postspinal hypotension in parturients undergoing LSCS. Secondary Objective • To observe the intraoperative systolic blood pressure, diastolic blood pressure, mean arterial pressure, perfusion index, heart rate. • Estimate the required dose of vasopressor used. Methodology- We divided all patients into 2 groups anticipating equal distribution of baseline PI on either side of cutoff point of 3.5 as suggested by a study by Toyama et al. Group I - Those with baseline PI≥3.5 Group II – Those with baseline PI <3.5 Spinal anaesthesia was given with the parturient in left lateral decubitus position using Quincke’s 23-gauge spinal needle with 11mg of injection bupivacaine 0.5% (hyperbaric) at the L3-L4 intervertebral space.Maternal HR, NIBP and PI were recorded at 2 min intervals after subarachnoid block upto 20 minutes and then at 5 minutes intervals till the end of surgery. Hypotension was defined as a decrease in MAP>20% from baseline based on a previous study. Result: The ROC analysis revealed that baseline PI was suitable for detecting part urients at risk for hypotension. The baseline PI cut-off point that predicted hypotension as detected by ROC analysis was 3.75 with a sensitivity 89% and specificity 84%.

 
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