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Differential Roles of the Right and Left Toe Perfusion Index in Predicting the Incidence of Postspinal Hypotension During Cesarean Delivery

Xu, Z.; Xu, T.; Zhao, P.; Ma, R.; Zhang, M.; Zheng, J.

Obstetric Anesthesia Digest: June 2018 - Volume 38 - Issue 2 - p 90–91
doi: 10.1097/01.aoa.0000532285.28591.56
Mechanisms, Equipment, Hazards
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(Anesth Analg. 2017;125(5):1560–1566)

Severe postspinal hypotension, which occurs in 70% of parturients, increases the risk of maternal and fetal complications. However, noninvasive methods used to predict spinal hypotension currently do not reflect aortocaval compression by the gravid uterus. One predictive method is the measurement of perfusion index (PI) parameters, usually measured via the finger. However, the authors of the present study speculated that measurement of toe PI may have greater predictive accuracy than finger PI and be associated with the incidence of postspinal hypotension in parturients. This is due to the fact that an underlying difference between finger and toe PI in supine parturients is the effect of direct aortocaval compression of the right iliac vessels by the gravid uterus.

Department of Anesthesiology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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