Correlation between peripheral perfusion index and total vasopressor dose, nausea/ vomiting, and uterine contraction after spinal anesthesia in cesarean section: A correlative cross-sectional observational study

Abstract

Background and Aims

Hypotension and other complications following spinal anaesthesia, such as nausea, vomiting, and poor uterine contractions during caesarean section, are common. There is no tool to predict the possibility of hypotension, nausea and vomiting, and poor uterine contractions to make proper anticipations. Peripheral Perfusion Index (PPI) is a noninvasive monitoring tool using an oximeter and can be used to indicate a patient's Systemic Vascular Resistance (SVR). This study aimed to find the correlation between pre-anaesthesia PPI and total vasopressor administration, nausea and vomiting, and uterine contraction using Linear Analogue Scale (LAS) after spinal anaesthesia for caesarean section.

Methods

The research subjects were 65 pregnant patients with the American Society of anaesthesiology II (ASA II) who underwent caesarean section at Hasan Sadikin General Hospital, Bandung, from November 2022 to April 2023. PPI was measured before spinal anaesthesia, and monitoring of nausea and vomiting, vasopressor administration, and LAS was performed intraoperatively.

Results

The results of this study showed that PPI had a strong positive correlation (r = 0.795) with total vasopressor administration, a moderate positive correlation (r = 0.506) with nausea and vomiting, and a moderate negative correlation (r = 0.574) with LAS. The AUC analysis revealed an excellent hypotension prediction with a cut-off value of 3.5 (AUC 0.868; CI 95%).

Conclusion

We conclude that PPI can be used as a predictor of vasopressor administration, nausea and vomiting, and uterine contractions.