Keywords
Lower Segment Cesarian Section
Perfusion Index
How to Cite
Abstract
Objective: To study the association of baseline Perfusion index with intraoperative hypotension in obstetric patients undergoing lower segment cesarean section in spinal anesthesia.
Methods: A Prospective observational study was conducted in the Anesthesia Department of Tertiary Care Hospital, Rawalpindi, from 1st Jan 2025 to 1st Oct 2025.
A total of 300 pregnant patients scheduled for spinal anesthesia for lower segment cesarean section were recruited for the study. Patients’ clinical data, including perfusion index was noted. After spinal anesthesia, the incidence of intraoperative hypotension and the treatment provided were noted. Mean and SD were calculated for Age, basic metabolic index, Perfusion Index, and time to hypotension. Student t test was applied to see the difference between the hypotensive and non-hypotensive groups.
Results: The mean age of the patients included in our study was 27.99±3.81 years. The distribution of women as per PI group was comparable, as 49% women had PI <3.5% and 51% woman had PI >3.5%. There was no statistically significant difference between age (p-value = 0.93), BMI (p-value = 0.11), and baseline systolic blood pressure between 2 groups. PI of Group A was 4.18 ± 1.33 Group B was 2.64 ± 0.93(p-value < 0.001). The Area Under the Curve (AUC) yielded as 3.5 optimal cutoff value with Sensitivity 79% and Specificity: 74%. Area under curve yielded 0.84 (95% CI: 0.76–0.92) with Optimal cutoff value for PI: >3.5, having Sensitivity of 79% and Specificity of 74%.
Conclusion: Perfusion index is a simple, safe, rapid, and reliable method that can predict intraoperative hypotension through pulse oximetry at the fingertip. A high PI of 3.5 or above can be used as a cutoff to predict hypotension along with other methods.
Keywords: Hypotension, Lower Segment Cesarian Section, Perfusion Index
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