Post Spinal Anesthesia Hypotension in Pregnant Women Undergoing Caesarian Section View PDF

Suha Kadhim Jameel Al-Zubaidi
Medicine, Kidney Diseases And Transplantation Center, Al-Sadder Teaching Hospital, Iraq

Published on: 2024-10-02

Abstract

The perfusion index (PI) is being regarded as a noninvasive monitoring aid for timely detection of hypotension following subarachnoid blockade (SAB). The aim was to establish the correlation of PI detect hypotension. An observational study was conducted by enrolled 100 women aged between 18 and 45 years. The study was conducted in our teaching hospitals from May 2022 till May 2023. The following parameters like blood pressure (BP), heart rate and oxygen saturation, PI and respiration were recorded. Spinal anesthesia (SA) was performed under strict aseptic precautions. Using a hyperbaric bupivacaine solution. It was found that there is a negative linear correlation between systolic BP (SBP) and PI. Moreover, the correlation was statistically significant (p < 0.01). There is a negative correlation between mean arterial pressure (MAP) and PI with statistic significant (p < 0.01). PI before and after oxytocin administration, the test showed that the up in PI after the administration of oxytocin was statistically significant (p < 0.05). Also, the decrease in PI after the administration of ephedrine was statistically significant (p < 0.05). PI as such alone can be used as a predictor of maternal hypotension after SA during caesarian section (CS). Moreover, the PI can also be used as a means to assess the response of ephedrine boluses and can help the anesthesiologist decide on further boluses or any other vasopressors. A significant effect posts the administration of oxytocin on the PI, which helps to assess the degree of hypotension which comes upon the administration of oxytocin

Keywords

Caesarian section, Hypotension, Perfusion index, Non-invasive blood pressure, Cubarachnoid blockade

Introduction

SA is the most preferable route in pregnancy undergo CS. Hypotension, is the most dreaded consequence of SA, that may impair the uteroplacental circulation, resulting in unfavorable maternal and fetal outcomes as fetal outcome include hypoxia, acidosis, altered consciousness, and cardiac arrest [1].

Over the years, many strategies have been employed to prevent or treat hypotension. The post spinal hypotension arises due to the blockade of the sympathetic nerve fibers which controls vascular smooth muscle tone [2].