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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