Prediction of intraoperative arterial hypotension associated with the spinal anesthesia. Prospective observational study
https://doi.org/10.35401/2541-9897-2023-26-2-28-33
Abstract
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.
About the Authors
M. P. Ivanova
Astana Medical University
Kazakhstan
Kazakhstan
Marina P. Ivanova, Cand. Sci. (Med.), Associate Professor, Anesthesiology, Intensive Care, and Emergency Pediatrics Department
Astana
V. A. Koriachkin
Saint Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Victor A. Koriachkin, Dr. Sci. (Med.), Professor at the Anesthesiology, Intensive Care, and Emergency Pediatrics Department named after V.I. Gordeev
Saint Petersburg
M. D. Ivanov
Saint Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Marat D. Ivanov, Assistant, Anesthesiology, Intensive Care, and Emergency Pediatrics Department named after V.I. Gordeev
Saint Petersburg
Yu. P. Malyshev
Kuban State Medical University
Russian Federation
Russian Federation
Yuriy P. Malyshev, Dr. Sci. (Med.), Professor, Department of Anesthesiology, Resuscitation, and Transfusiology, Faculty of Continuing Professional Development and Retraining
Krasnodar
V. A. Zhikharev
Kuban State Medical University
Russian Federation
Russian Federation
Vasiliy A. Zhikharev, Dr. Sci. (Med.), Assistant, Department of Anesthesiology, Resuscitation, and Transfusiology, Faculty of Continuing Professional Development and Retraining
ulitsa M. Sedina 4, Krasnodar, 350063, Russian Federation
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Review
For citations:
Ivanova M.P., Koriachkin V.A., Ivanov M.D., Malyshev Yu.P., Zhikharev V.A. Prediction of intraoperative arterial hypotension associated with the spinal anesthesia. Prospective observational study. Innovative Medicine of Kuban. 2023;(2):28-33. (In Russ.) https://doi.org/10.35401/2541-9897-2023-26-2-28-33
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