Peripheral Perfusion Index as a Predictor of Post-Spinal Hypotension in Patients Undergoing Lower Abdominopelvic Surgeries

Abstract Background One of the main complications of spinal anesthesia is post spinal hypotension. And since noninvasive hemodynamic & blood pressure monitoring are the standards in most surgical procedures, ensuring best & safest monitoring standards has been of utmost importance. The use of plethysmography in anesthesia monitoring has become one of the essential tools in any anesthetic procedures. However, its varying interpretations & usages haven't been explored to the fullest. Objective To assess predictability of baseline peripheral perfusion index to Post spinal hypotension in patients undergoing elective lower abdomino-pelvic surgeries. Methods This Prospective Observational study was conducted in Ain Shams University Hospitals’ operating rooms. And was conducted over a period of 6 months after approval of ethical committee of Faculty of Medicine, Ain Shams University, All patients undergoing elective lower abdominopelvic surgeries at El-demerdash Hospital of Surgery during the study period. Surgeries include inguinal / inguinoscrotal hernia repair, paraumbilical hernia repair, lower laparotomies, transurethral resection of bladder tumor, simple gynecological procedures. Results This study showed that Perfusion index can be used as a predictor for hypotension in patients undergoing elective lower abdominopelvic surgeries under spinal anesthesia. Patients with baseline PI > 0.9 are at greater risk of developing hypotension after spinal anesthesia when compared with those with baseline PI ≤ 0.9. Hence, peripheral perfusion index usage can be recommended in this regard. Conclusion This study concluded that Perfusion index can be used as a predictor for hypotension in patients undergoing elective lower abdominopelvic surgeries under spinal anesthesia. Patients with baseline PPI >0.9 are at greater risk of developing hypotension after spinal anesthesia when compared with those with baseline PPI ≤0.9 .Hence, peripheral perfusion index usage can be recommended in this regard.