Prediction of Intraoperative Arterial Hypotension Associated With the Spinal Anesthesia. Prospective Observational Study

Прогнозирование интраоперационной артериальной гипотонии при спинальной анестезии: проспективное обсервационное исследование
Ivanova M.P. Koriachkin V.A. Ivanov M.D. Malyshev Y.P. Zhikharev V.A.
2023 Scientific Research Institute — Ochapovsky Clinical Regional Hospital no. 1

Innovative Medicine of Kuban
2023 Issue 2 28 - 33 pp.

Background: 90% of C-sections are supported by spinal anesthesia, which is complicated by arterial hypotension in 60%-80% of cases. The perfusion index seems to be a significant prognostic tool for arterial hypotension. Objective: Тo confirm the value of perfusion index in predicting arterial hypotension associated with the spinal anesthesia. Materials and methods: The study included 105 female patients who underwent С-section under spinal anesthesia. A decrease in mean arterial pressure by ≤ 20% was considered as arterial hypotension. Baseline perfusion index was assessed with a pulse oximeter. Results: 68 patients (64.8%) developed arterial hypotension in the intraoperative period. In 37 (35.2%) parturient women there were no significant changes in blood pressure. A cut-off threshold of 3.1 with 75% sensitivity and 75% specificity was obtained with the ROC analysis. Arterial hypotension developed in 29.4% (n = 15) of parturient women with a perfusion index < 3.1 and in 72.2% (n = 39) of parturient women with a perfusion index > 3.1. Conclusions: We can use the perfusion index threshold of 3.1 to identify parturient women with an increased risk of arterial hypotension associated with the spinal anesthesia for C-section. The arterial hypotension rate is significantly higher in women with an initial perfusion index > 3.1 compared with those with an initial perfusion index < 3.1.

arterial hypotension , C-section , perfusion index , spinal anesthesia

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Anesthesiology, Intensive Care, and Emergency Pediatrics Department, Astana Medical University, Astana, Kazakhstan
Anesthesiology, Intensive Care, and Emergency Pediatrics Department named after V.I. Gordeev, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russian Federation
Department of Anesthesiology, Resuscitation, and Transfusiology, Faculty of Continuing Professional Development and Retraining, Kuban State Medical University, Krasnodar, Russian Federation

Anesthesiology
Anesthesiology
Department of Anesthesiology

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