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The aim of this study is to investigate the predictability of hypotension by using PI and PVI in pre-and post-spinal anesthesia periods in cesarean section cases in the sitting position.
Spinal anesthesia has been widely used all over the world due to its superiority to general anesthesia in cesarean section. However, as a result of the sympathetic blockade in spinal anesthesia, vascular tone decreases and hypotension occurs. The incidence of hypotension increases up to 70% in pregnant women due to increased sensitivity to local anesthetics and increased intraabdominal pressure. Improper management of postspinal hypotension may lead to maternal and fetal complications. Predicting the risk of hypotension in patients undergoing spinal anesthesia may allow applications such as volume loading or prophylactic vasopressor use. The perfusion index, measured by pulse Oximeters, correlates with blood flow changes at the tip of the finger so that it can detect hypotension and thus decrease in blood flow after spinal anesthesia. Pleth variability index (PVI) is a non-invasive value found in the new generation pulse oximeters. It is a parameter used in the dynamic measurement of response to fluid therapy in intensive care units. PVI can dynamically give an idea about the fluid status of the pregnant woman. Previous studies have shown that PVI may be a marker for predicting hypotension following spinal anesthesia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Non-hypotension | Patients with a mean arterial pressure reduction of less than 20% and/or systolic arterial pressure above 80 mmHg after spinal anesthesia. |
| |
| Hypotension | Patients with a 20% reduction in mean arterial pressure and/or systolic arterial pressure below 80 mmHg after spinal anesthesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Masimo Radical-7® Pulse CO-Oximeter® | Device | The perfusion index and Pleth variability index will be recorded from the device monitor. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Perfusion index | Perfusion index will be recorded from the monitor. | Before spinal anesthesia in supine positon |
| Pleth variability index | Pleth variability index will be recorded from the monitor. | Before spinal anesthesia in supine positon |
| Perfusion index | Perfusion index will be recorded from the monitor. | Before spinal anesthesia in sitting positon |
| Pleth variability index | Pleth variability index will be recorded from the monitor. | Before spinal anesthesia in sitting positon |
| Perfusion index | Perfusion index will be recorded from the monitor. | 1 minutes after spinal anesthesia in supine positon |
| Pleth variability index | Pleth variability index will be recorded from the monitor. | 1 minutes after spinal anesthesia in supine positon |
| Perfusion index | Perfusion index will be recorded from the monitor. | Start of the surgery |
| Pleth variability index | Pleth variability index will be recorded from the monitor. |
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Inclusion Criteria:
Exclusion Criteria:
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Pregnant women who will undergo elective cesarean section
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| Name | Affiliation | Role |
|---|---|---|
| Erhan OZYURT, MD | University of Health Sciences, Antalya Training and Research Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Health Sciences, Antalya Training and Research Hospital | Antalya | 07100 | Turkey (Türkiye) |
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| Start of the surgery |
| Perfusion index | Perfusion index will be recorded from the monitor. | 1 minutes after the umbilical cord clamping |
| Pleth variability index | Pleth variability index will be recorded from the monitor. | 1 minutes after the umbilical cord clamping |