Use of pulse oximeter to predict hypotension during surgery

Not yet recruiting

Brief Summary: All patients will undergo general physical examination and routine investigation according to the institutional protocol. Informed consent will be taken. Patients will be kept nil per mouth for 6 hours before surgery. IV line will be secured with an 18 or 20 G intravenous catheter. Infusion of Ringer’s lactate will be started. In the operating room, ASA Standard monitors will be attached. Baseline PVI, PI, HR, BP and SPO2 will be measured in a supine position. Pulse oximetry and PVI values are automatically calculated from pulse oximetry in the operating room after the patients have rested for 5 min using a Masimo-finger pulse oximeter in the index finger. The preoperative PVI value taken at this point will be recorded as basal PVI. Spinal anaesthesia will be given with a 25G Quincke’s spinal needle in a sitting position with 15 mg of 0.5 per cent heavy bupivacaine. HR, SBP, MAP, SPO2, and PVI will be measured every minute for an initial 10 minutes and then every 5 minutes up to 30 minutes in a supine position. The sensory level will be checked using a spirit swab for a cold sensation. The assessment of motor blockade will be done using a modified Bromage scale. The surgery will commence once the T6 dermatomal level is achieved. Hypotension is defined as SBP less than 90 mmHg or a 20 per cent fall from baseline or MAP less than 65 mmHg. Hypotension will be treated with Inj. Ephedrin 6 mg bolus and Fluid bolus of RL at 10 to 15ml per kg.

Recruitment & Eligibility

Inclusion Criteria

Adult patients between 18 and 60 years undergoing infra-umbilical surgeries under spinal anaesthesia.
ASA Physical Status 1 or 2.
Consent to participate in the study.
Patient undergoing infraumbilical surgeries requiring 15 mg of 0.5 per cent of Bupivacaine heavy in subarachnoid block.

Exclusion Criteria

Primary Outcome Measures

Name	Time	Method
Determine the correlation between preoperative PVI values and the incidence of Spinal anaesthesia induced hypotension.	One year

Secondary Outcome Measures

Name	Time	Method
Establish a Pleth variability index (PVI) threshold for predicting hypotension.	Assess the sensitivity & specificity of PVI as a predictor

Locations (1): MVJ medical college and research hospital
🇮🇳
Rural, KARNATAKA, India
MVJ medical college and research hospital
🇮🇳Rural, KARNATAKA, India
Dr Haripriya R
Principal investigator
08970766376
haripri20@gmail.com