Comparative Study between the Perfusion Index and Positional Haemodynamic Changes for Prediction of Hypotension after Spinal Anaesthesia in Caesarean Section

Hypotension following spinal anaesthesia may cause maternal dizziness, nausea, vomiting and fetal acidosis, administration of prophylactic vasopressor agents in pregnant women may cause undesirable effects on the mother and fetus. Perfusion index is the ratio of a pulsatile to a non-pulsatile fraction of blood volume. The increase of the pulsatile fraction manifested during vasodilatation corresponds to a higher PI. So, the patients with a higher PI have a higher risk for post-spinal hypotension. Elevated sympathetic activity before neuraxial anaesthesia was associated with a higher risk for post-spinal hypotension. The significant variability in haemodynamic after the positional change indicates higher sympathetic activity. The high the rise in autonomic activity, the higher the risk for post-spinal hypotension

AIM OF THE WORK:

Prediction of hypotension after spinal anaesthesia in caesarean section either by perfusion index and positional haemodynamic changes

Grouping:

All the recruited patients will be assessed by perfusion index. and by positional haemodynamic changes

Inclusion criteria

• Parturient acceptance.
• American Society of Anesthesiologists (ASA) II
• arturient with be gestational age >36 weeks and <41 weeks.
• Body mass index (BMI) ≤35kg/m2
• elective caesarean section delivery

Exclusion criteria

• preeclampsia
• eclampsia,
• gestational diabetes
• Contraindication to regional anaesthesia as allergy, coagulation abnormalities or infection in site of injection.

Pregnant female patients above 18 years who will undergo cesarean section

Pregnant women undergoing an elective caesarean section delivery.