Background and Aims: Hypotension during spinal anaesthesia for caesarean section is a common and important problem with foetal and maternal implications. Perfusion Index (PI) observes from a pulse oximeter has been used for assessing peripheral perfusion dynamics due to changes in peripheral vascular tone. The aim of this study was to determine whether a baseline PI can predict hypotension after spinal anaesthesia for caesarean section.

Methods: In this prospective observational study, 60 pregnant women were divided into two groups on the basis of PI. Group 1 included those with PI > 3.5 and group II, those with PI£3.5. Spinal anaesthesia was given with 2ml of 0.5% bupivacaine (hyperbaric) in L3-L4 or L2-L3 inter space. A mean arterial pressure (MAP) of < 65mm of Hg is defined as hypotension. Statistical analysis was performed using independent sample t-test and chi-square test. Receiver operating characteristic (ROC) curve was plotted for PI and occurrence of hypotension. 

Results: The incidence of hypotension is 86.67% in group I whereas it is 6.67% in group II. The correlation between baseline PI>3.5 and the number of episodes of hypotension and the dose of vasopressors was also significant. The sensitivity and specificity of baseline PI of 3.5 to predict hypotension was 86.67% and 93.33% respectively. The area under the ROC curve for PI to predict hypotension was 0.911.

Conclusion: The incidence of hypotension following spinal anaesthesia for caesarean section is high in parturient with baseline PI>3.5.

Keywords: Perfusion index, spinal anaesthesia, hypotension, pregnancy

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Dr Regimol V Varghese                        

Assistant Professor in Anaesthesiology, Govt Medical College, Kottayam, India

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