Citation Information :
Patodi V, Sharma A, Meena D, Jain K, Jain N, Mathur V. Perfusion Index as a Predictor of Hypotension Following Spinal Anesthesia in Lower Abdominal Surgery. Res Inno in Anesth 2021; 6 (2):31-35.
Background: Subarachnoid block (SAB) is a gold standard anesthetic technique for lower abdominal surgeries. Hypotension is a very common observation following a SAB. Perfusion index (PI) is a new parameter that can be used as a noninvasive method to find out the chances of developing hypotension after SAB.
Aim and objective: The aim and objective of this study was find out the relation between baseline PI and the likelihood of developing hypotension after SAB in lower abdominal surgeries.
Materials and methods: Our study was a prospective randomized observational study. In this study, patients were allocated in two groups according to the baseline PI. Group I includes patients with baseline PI ≤3.5 and group II includes patients with baseline PI > 3.5. Subarachnoid block with 15 mg 0.5% heavy bupivacaine at l4–l5 level or l3–l4 level intervertebral space was given and hypotension was mentioned as mean blood pressure <65 mm Hg.
Results: The hypotension in group I was 12.28% whereas in group II was 74.58%. The receiver operating characteristic (ROC) curve showed that baseline PI could be a useful parameter for detecting patients at risk of developing hypotension. The area under the ROC curve for the prediction of hypotension was 0.912. The specificity and sensitivity of PI (baseline) of 3.3 to find hypotension were 75.38 and 94.12%, respectively.
Conclusion: For predicting hypotension, PI can be used in patients having below umbilical surgeries under SAB. Therefore, it can be said that patients with PI (baseline) >3.5 have higher chances of developing hypotension than patients with PI <3.5.
Ginosar Y, Weiniger CF, Meroz Y, et al. Pulse oximeter perfusion index as an early indicator of sympathectomy after epidural anesthesia. Acta Anaesthesiol Scandina 2009;53(8):1018–1026. DOI: 10.1111/j.1399-6576.2009.01968.x.
Lima A, van Genderen ME, Klijn E, et al. Peripheral vasoconstriction influences thenar oxygen saturation as measured by near-infrared spectroscopy. Intens Care Med 2012;38(4):606–611. DOI: 10.1007/s00134-012-2486-3.
Shah SB, Hariharan U, Bhargava AK. Novel perioperative utilities of the newer co oximetery parameters: a practical review. EC Anaesth 2016;2(5).
Mallawaarachchi RP, Pinto V, De Silva PH. Perfusion index as an early predictor of hypotension following spinal anesthesia for cesarean section. J Obstet Anaesthe Crit Care 2020;10(1):38. DOI: 10.4103/joacc.JOACC_39_18.
Toyama S, Kakumoto M, Morioka M, et al. Perfusion index derived from a pulse oximeter can predict the incidence of hypotension during spinal anaesthesia for caesarean delivery. Br J Anaesth 2013;111(2):235–241. DOI: 10.1093/bja/aet058.
Duggappa DR, Lokesh MP, Dixit A, et al. Perfusion index as a predictor of hypotension following spinal anaesthesia in lower segment caesarean section. Indian J Anaesth 2017;61(8):649. DOI: 10.4103/ija.IJA_429_16.
Varghese RV. Perfusion Index Assessed from a Pulse Oximeter as a Predictor of Hypotension during Spinal Anesthesia for Caesarean Section.
Gupta A, Dubey A, Pandey A, et al. Perfusion index derived from pulse oximeter as a predictor of hypotension following sub arachnoid block for below umbilical surgery. IJSR 2019;8(10):61–63.
George J, Valiaveedan SS, Thomas MK. Role of perfusion index as a predictor of hypotension during spinal anaesthesia for caesarean section-a prospective study. J Med Sci Clin Res 2019;7(3):1208–1216.