Perfusion Index vs Positional Hemodynamic Changes to Predict Hypotension After Spinal Anaesthesia in Caesarean Section

Study Overview
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Brief Summary
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Comparative Study between the Perfusion Index and Positional Haemodynamic Changes for Prediction of Hypotension after Spinal Anaesthesia in Caesarean Section

Detailed Description
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Hypotension following spinal anaesthesia may cause maternal dizziness, nausea, vomiting and fetal acidosis, administration of prophylactic vasopressor agents in pregnant women may cause undesirable effects on the mother and fetus. Perfusion index is the ratio of a pulsatile to a non-pulsatile fraction of blood volume. The increase of the pulsatile fraction manifested during vasodilatation corresponds to a higher PI. So, the patients with a higher PI have a higher risk for post-spinal hypotension. Elevated sympathetic activity before neuraxial anaesthesia was associated with a higher risk for post-spinal hypotension. The significant variability in haemodynamic after the positional change indicates higher sympathetic activity. The high the rise in autonomic activity, the higher the risk for post-spinal hypotension AIM OF THE WORK: Prediction of hypotension after spinal anaesthesia in caesarean section either by perfusion index and positional haemodynamic changes Grouping: All the recruited patients will be assessed by perfusion index. and by positional haemodynamic changes

Official Title
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Comparative Study Between the Perfusion Index and Positional Haemodynamic Changes for Prediction of Hypotension After Spinal Anaesthesia in Caesarean Section

Conditions
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Post Spinal Hypotension

Intervention / Treatment
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* Other: perfusion index in all parturient recruited for the study


Participation Criteria
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Eligibility Criteria
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Inclusion criteria Parturient acceptance. American Society of Anesthesiologists (ASA) II arturient with be gestational age >36 weeks and <41 weeks. Body mass index (BMI) ≤35kg/m2 elective caesarean section delivery Exclusion criteria preeclampsia eclampsia, gestational diabetes Contraindication to regional anaesthesia as allergy, coagulation abnormalities or infection in site of injection.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Observational study in parturient who will be recruited for the study<br>this study will include the eligible parturient who will be assessed by perfusion index and by positional hemodynamic changes. | Other: perfusion index in all parturient recruited for the study<br>* Using perfusion index and positional hemodynamic changes for the prediction of postspinal hypotension in all parturient recruited for the study<br>* Other names: positional haemodynamic changes between supine and right lateral position in parturient .;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prediction of post-spinal hypotension using PI | To correlate between perfusion index and hypotension after spinal anaesthesia in caesarean section | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prediction of post-spinal hypotension using positional hemodynamic changes | To correlate between positional haemodynamic changes and hypotension after spinal anaesthesia in caesarean section | 6 months |