Perfusion Index as a Noninvasive Early Warning Tool for Postspinal Hypotension in Elective Caesarean Sections
Sreyoshi Som, Shubhada AphaleAbstract
Aim:
To evaluate the diagnostic accuracy of the perfusion index (PI) in predicting postspinal hypotension (PSH) in parturients undergoing elective lower segment caesarean section (LSCS) under subarachnoid block (SAB).
Methods:
This prospective observational study included 99 parturients above 36 weeks gestation undergoing elective LSCS under SAB. Perfusion index and hemodynamic variables were monitored using Masimo pulse oximetry. Hypotension was defined as SBP <80 mmHg and/or MAP <50 mmHg. Receiver operating characteristic (ROC) curve analysis was used to determine PI cut-off values predictive of hypotension.
Results:
PSH occurred in 51.5% of patients. PI at 15 minutes post-SAB significantly predicted hypotension at 20 minutes with an AUC of 0.972, sensitivity of 82.14%, and specificity of 91.55% at a cutoff of 10.85. Baseline PI had poor predictive value (AUC 0.490,
Conclusion:
PI measured at 15 minutes post-SAB is a strong predictor of PSH at 20 minutes. Timely monitoring of PI can guide individualized fluid and vasopressor therapy.