الفهرس 
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Abstract
O
ne of the main complications of spinal anesthesia is post spinal hypotension. And since noninvasive hemodynamic & blood pressure monitoring are the standards in most surgical procedures, ensuring best & safest monitoring standards has been of utmost importance.
The use of plethysmography in anesthesia monitoring has become one of the essential tools in any anesthetic procedures. However, its varying interpretations & usages haven’t been explored to the fullest.
The purpose of this study was to assess predictability of baseline peripheral perfusion index to Post spinal hypotension in patients undergoing elective lower abdomino-pelvic surgeries.
A sample of 40 patients were selected according to our inclusion and exclusion criteria from population of patients undergoing elective lower abdominopelvic surgeries at El-demerdash Hospital of Surgery during the study period.
Patients were monitored during the operation using electrocardiography, pulse oximeter (SpO2), automated non-invasive arterial pressure (NIAP) measurement cuff, and Masimo pulse oximeter probe for measuring PPI before spinal anesthesia.
Normothermia was maintained using warm intravenous fluids and a forced air warmer & Supplemental oxygen was given through nasal prongs at a flow rate of 4 L/min.
Baseline PPI values were recorded before spinal anesthesia. SAP, MAP, HR and were recorded throughout the surgery at timely intervals.
Hypotension was defined as a decrease in SAP ≥25% from baseline. When SAP decreases to this level, a bolus of ephedrine hydrochloride was given as a rescue medication at a dose of 0.1 mg/kg.
Results of this study:
This study showed that Perfusion index can be used as a predictor for hypotension in patients undergoing elective lower abdominopelvic surgeries under spinal anesthesia. Patients with baseline PI >0.9 are at greater risk of developing hypotension after spinal anesthesia when compared with those with baseline PI ≤0.9. Hence, peripheral perfusion index usage can be recommended in this regard.