Clinical trial NCT05269407: The Ability of the Change in Positional Perfusion Index in Predicting Post-spinal Anesthesia Hypotension in Caesarian Section
Official title: The Ability of the Change in Positional Perfusion Index in Predicting Post-spinal Anesthesia Hypotension in Caesarian Section
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Obstetric Anesthesia Problems
Lead sponsor: Cairo University
Sponsor class: OTHER
First posted: 2022-03-08
Enrollment: 115
Sex: ALL
Minimum age (years): 18
Maximum age (years): 50
Standard ages: ADULT
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: A total of 115 consecutive adult female patients, aged \>18 years scheduled for the elective caesarian section under spinal anesthesia will be included in the study.

Brief summary: Our study aims to investigate the value of postural perfusion index changes as a non-invasive method to predict hypotension following spinal anesthesia for elective cesarean delivery.

Detailed description: The perfusion index is the ratio of pulsatile blood flow to non-pulsatile in peripheral tissues and can be measured non-invasively using a pulse oximeter .Perfusion index measurement is considered a non-invasive rapid indicator of microcirculation variation and can help to detect circulation disturbance.It also can assess peripheral perfusion dynamics resulting from changes in peripheral vascular tone. Perfusion index changes according to posture with its highest value in Trendelenburg position and lowest value during 45-degree sitting position. However, to the best of our knowledge, no studies have studied the effect of posture on perfusion index in a full-term pregnancy, and its ability to predict hypotension following spinal anesthesia for elective cesarean delivery.

A previous study had found a correlation between baseline perfusion index and the incidence of post-spinal hypotension in the cesarean section, however, they haven't studied the effect of postural change on PI and its predictability of post-spinal induced hypotension(,Our study aims to investigate the value of postural perfusion index changes as a non-invasive method to predict hypotension following spinal anesthesia for elective cesarean delivery.

Eligibility criteria: Inclusion Criteria:

* ASA physical status 1-2 Age \> 18 years uncomplicated singleton pregnancy at full-term Elective scheduled caesarian section under spinal anesthesia

Exclusion Criteria:

* pre-existing hypertension gestational hypertension or preeclampsia Diabetes mellitus, or autonomic neuropathy Patients with peripheral vascular diseases known fetal abnormality. Emergency caesarian section. Placenta previa or placenta accrete. absolute contraindications or failure to perform spinal anesthesia.Study

Primary outcomes:
measure: Sensitivity of positional index in predicting post-spinal hypotension
timeFrame: 30 minutes post spinal anesthesia
Secondary outcomes:
measure: The sensitivity of sitting perfusion index to predict post-spinal anesthesia hypotension in caesarian section.
timeFrame: 30 minutes post spinal anesthesia
measure: The sensitivity of supine perfusion index to predict post-spinal anesthesia hypotension in caesarian section.
timeFrame: 30 minutes post spinal anesthesia
measure: The correlation between perfusion index postural change and the degree of severity of hypotension in caesarian section post spina anesthesia.
timeFrame: 30 minutes post spinal anesthesia
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Faculty of Medicine
Study officials:
References: