CORRELATION OF PERFUSION INDEX WITH BASELINE HEART RATE AND POST SPINAL HYPOTENSION IN PREGNANT PARTURIENTS POSTED FOR LSCS-A PROSPECTIVE OBSERVATIONAL STUDY

Authors: THARUN DASARATH PERNI, Sandip Narayan Baheti, SIDDHARTH S BAHETI

DOI: 10.18231/j.ijca.10925.1759482773

Keywords: Perfusion index, heart rate, spinal anesthesia, hypotension, LSCS, cesarean section, maternal hemodynamics, vasopressor.

Abstract: Background: Post-spinal hypotension is a common and significant complication during lower segment cesarean section (LSCS), potentially compromising maternal and fetal outcomes. Identifying reliable preoperative predictors is crucial for early intervention. Aim: To evaluate the correlation between pre-induction perfusion index (PI), baseline heart rate (HR), and the incidence of post-spinal hypotension in parturients undergoing LSCS under spinal anesthesia. Methods: This prospective observational study included 150 pregnant women scheduled for elective LSCS under spinal anesthesia. Baseline PI and HR were recorded before induction. Hypotension was defined as a >20% decrease in systolic blood pressure (SBP). Considered baseline PI as 3.5, and outcomes were analyzed in terms of incidence of hypotension and vasopressor requirement. Results: No statistically significant correlation was found between baseline PI and the occurrence of hypotension based on SBP (p=0.396) or MAP (p=0.477). A new PI threshold of >6.2 (SBP) and <1.7 (MAP) showed moderate specificity but low sensitivity. However, a significant association was found between elevated baseline HR and post-spinal hypotension, with higher HRs indicating greater susceptibility (p=0.0004 for SBP-based, p=0.012 for MAP-based hypotension). Conclusion: Perfusion index alone may not be a reliable predictor of post-spinal hypotension in parturients. Baseline heart rate demonstrates stronger predictive value and may serve as a simple, non-invasive marker for early risk identification. Further studies with larger populations are recommended to validate these findings.