Evaluation of perfusion index to predict hypotension in lower segment caesarean section under spinal anaesthesia
Journal Title: International Journal of Public Health Asia Pacific (IJPHAP) - Year 2024, Vol 3, Issue 6
Abstract
Background: Spinal Anaesthesia is the most popular choice for elective caesarean section. Both general anaesthesia and regional anaesthesia are acceptable techniques for anaesthesia for elective and emergency caesarean sections. Objectives: The study aimed to investigate the role of the perfusion index in predicting the incidence of hypotension following spinal anaesthesia in parturients undergoing elective lower segment caesarean sections. Methods: A prospective observational study was carried out among sixty parturients posted for elective caesarean section. The study was conducted in the operation theatres of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. About 60 participants were interviewed for the study. Data were entered and analysed with the help of the Statistical Package for Social Science (SPSS) version.16. Results: Sixty eligible ASAI (American society of anaesthesiologist’s physical status classification) parturients scheduled for elective caesarean section were divided into two groups pre-operatively after determining their baseline Perfusion Index (PI) as those with PI ≤ 3.5 and those with PI > 3.5 using a Masimo® pulse oximeter probe. When comparing the heart rate at time intervals among the two groups, it became increasingly clear that those with baseline PI > 3.5 had generally higher heart rate especially immediately after the block and at 2nd, 4th, 6th,8th, 10th, 12th, 14th and 20th minutes. Conclusion: The study concludes that a Perfusion Index > 3.5 is associated with a higher incidence of hypotension in lower segment caesarean section under spinal anaesthesia. The hemodynamic parameters such as increased heart rate and significantly lower systolic, diastolic and mean arterial pressures in parturients with baseline PI > 3.5 suggest that these patients have lower baseline SVR and depleted autonomic resilience to hypotension compared to those with baseline PI ≤ 3.5. High BMI seems to be significantly associated with high baseline PI.
Authors and Affiliations
Abiral Nidhi, Dipendra Kumar Yadav, Subodh Kumar Sharma, Sushila Baral, Ayushi Rai Nidhi, Rajesh Kumar Yadav
Hyperemesis Gravidarum: fetal and maternal complications in a Tertiary Hospital in Nepal
Background: Hyperemesis gravidarum (HG) is a syndrome that occurs in the first half of pregnancy and is manifested by severe vomiting. The vomiting can cause weight loss, dehydration, ketonuria and electrolyte imbalance...
Factors influencing childbearing intention among married women of reproductive age in Bueng Kan Province
Background: Globally, the total fertility rate (TFR), the average of births per woman has declined from 3.2 in 1990 to 2.3 in 2020. There have been at least 23 countries whose population has decreased by 50%, including T...
Study on hospitalization cost of elderly patients with lung cancer in the Western region of China
Background: By collecting the medical record information of hospitalization cost (HC) of the elderly over 60 years, to comprehensively analyze the influencing factors of the rise of HC from the internal and external dime...
Client satisfaction with health services provided under Social Health Insurance Scheme in selected wards of Banepa municipality, Nepal
Background: Social Health Insurance schemes are integral in achieving Universal Health Coverage by enhancing the affordability of quality healthcare services. Evaluating client satisfaction with healthcare services under...
Healthcare provider's experience and attitude towards the national health insurance program of Nepal
Background: Universal Health Coverage (UHC) aims for accessible quality healthcare for all, without financial strain. Nepal's National Health Insurance Program (NHIP), launched in 2016, strives towards this goal by offer...