Prediction of Hypotension Using Perfusion Index Following Spinal Anesthesia in Lower Segment Caesarean Section

Study Overview
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Brief Summary
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Spinal anesthesia for caesarean section is invariably associated with variable degree of hypotension. Hypotension that occurs may be detrimental to various organ system due to inadequate perfusion. Various methods and agents have been tried in order to address this problem. However, this calamity is far from over. Perfusion index is one such attempt to address the problem of hypotension by predicting which group of parturient may develop hypotension. This is a type of non-invasive method of assessing the relative vascular tone with the use of pulse oximeter which calculates the ration of pulsatile versus the non-pulsatile component of the blood flow. During normal physiological changes in pregnancy, there is relative loss of vascular tone which predisposes this group of patient to sudden development of hypotension after the sympathetic block due to spinal anesthesia. Thus, the aim of the study is to use the non-invasive perfusion index data to predict the occurrence of hypotension in a parturient so that helps us to guide fluid and other drug therapy to address the problem of hypotension.

Official Title
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Prediction of Hypotension Using Perfusion Index Following Spinal Anesthesia in Lower Segment Caesarean Section

Conditions
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Spinal, Hypotension, Perfusion Index

Intervention / Treatment
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* Device: Perfusion Index


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA II physical status. Planned for elective LSCS Gestational age >36 weeks and <41 weeks Exclusion Criteria: Patient's refusal. Emergency LSCS. Patient's with contraindications to spinal anesthesia Patient with BMI >40, preeclampsia, placenta praevia. Patients with comorbidities like cerebrovascular or cardiovascular disease, and gestational diabetes.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group I (Perfusion Index <3.5)<br>Those parturient with perfusion index <3.5 when baseline monitors are attached while the patient is being prepared for surgery. | Device: Perfusion Index<br>* Use of non-invasive pulse oximeter to determine perfusion index<br>|
| Group II (Perfusion index >3.5)<br>Those parturient with perfusion index >3.5 when baseline monitors are attached while the patient is being prepared for surgery. | Device: Perfusion Index<br>* Use of non-invasive pulse oximeter to determine perfusion index<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of hypotension | compare the incidence of hypotension following SAB for LSCS in parturient with or without a high perfusion index. | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perfusion index | To compare the perfusion index (PI) at various intervals between the two groups | 3 months | 
| Side-effects | To study the profile of side effects between the two groups. | 3 months | 
| Systolic blood pressure | To compare the systolic blood pressure (SBP) at various intervals between the two groups. | 3 months | 
| Diastolic blood pressure | To compare the diastolic blood pressure (DBP) at various intervals between the two groups. | 3 months | 
| Mean arterial pressure | To compare the mean arterial pressure (MAP) at various intervals between the two groups | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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spinal hypotension, perfusion index, caesarean section