Perfusion Index and Positional Blood Pressure Changes as Preoperative Predictors for Post-Spinal Hypotension in Caesarean Section: An Observational Study
Attia, Z., Abdelgalel, E., Alsewe, R., Abdelhaleem, N. (2023). Perfusion Index and Positional Blood Pressure Changes as Preoperative Predictors for Post-Spinal Hypotension in Caesarean Section: An Observational Study. EKB Journal Management System, 90(2), 3047-3052. doi: 10.21608/ejhm.2023.288388
Zainab M. Attia; Essam F. Abdelgalel; Ramy M. Alsewe; Naglaa Fathy Abdelhaleem. "Perfusion Index and Positional Blood Pressure Changes as Preoperative Predictors for Post-Spinal Hypotension in Caesarean Section: An Observational Study". EKB Journal Management System, 90, 2, 2023, 3047-3052. doi: 10.21608/ejhm.2023.288388
Attia, Z., Abdelgalel, E., Alsewe, R., Abdelhaleem, N. (2023). 'Perfusion Index and Positional Blood Pressure Changes as Preoperative Predictors for Post-Spinal Hypotension in Caesarean Section: An Observational Study', EKB Journal Management System, 90(2), pp. 3047-3052. doi: 10.21608/ejhm.2023.288388
Attia, Z., Abdelgalel, E., Alsewe, R., Abdelhaleem, N. Perfusion Index and Positional Blood Pressure Changes as Preoperative Predictors for Post-Spinal Hypotension in Caesarean Section: An Observational Study. EKB Journal Management System, 2023; 90(2): 3047-3052. doi: 10.21608/ejhm.2023.288388

Perfusion Index and Positional Blood Pressure Changes as Preoperative Predictors for Post-Spinal Hypotension in Caesarean Section: An Observational Study

The Egyptian Journal of Hospital Medicine
Article 161, Volume 90, Issue 2, January 2023, Page 3047-3052  XML PDF (781.28 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2023.288388
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Authors
Zainab M. Attia; Essam F. Abdelgalel; Ramy M. Alsewe email ; Naglaa Fathy Abdelhaleem
Abstract
Background: Spinal anesthesia (SA) remains the most popular anesthetic technique for caesarean sections (CS), as it abolishes the possible risks of pregnant airway management. The ability to anticipate the episodes of hypotension following spinal anesthesia will enable anesthesiologists to interfere early and provide better patient management. Objective: The aim of the current study was toevaluate the perfusion index and the blood pressure positional changes in the prediction of hypotension after SA in CSs. Patients and methods: A prospective cohort study was conducted at the Obstetrics and Gynecology Department of Zagazig University Hospitals. A total of 80 pregnant women who were prepared for elective CS delivery, aged from 18 to 40 years with ASA-II (American Society of Anesthesiologists Status), were recruited in the current study. Results: The mean perfusion index (PI) pre-spinal was 5.81 and immediately after spinal was 4.65 with a statistically significant decrease (P<0.001). There was also a statistical difference between the mean of mean arterial pressure (MAP) of the studied cases pre-spinal at the lateral position (91.76 mmHg) and mean MAP in the supine position (83.29 mmHg) with P-value <0.001, with a mean difference of 8.48 mmHg. PI cut-off >4 had a sensitivity of 85.9%, specificity of 75%, and accuracy of 83.8% in the prediction of hypotension. The positional change in blood pressure at cut-/off >5 mmHg had a sensitivity of 82.8%, specificity of 75%, and accuracy of 81.3% in the prediction of hypotension among cases. Conclusion: The preoperative PI and positional blood pressure change can predict spinal anesthesia induced hypotension during caesarean deliveries.
 
Keywords
Caesarean section; Spinal anesthesia; Perfusion index
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