Analgesia nociception index as a tool to predict hypotension after spinal anaesthesia for elective caesarean section.

Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology
Ali JendoubiMohamed Houissa

Abstract

Arterial hypotension is the main disadvantage of spinal anaesthesia (SA) for caesarean delivery with deleterious effects on maternal-foetal outcomes. Recently, a non-invasive device 'analgesia nociception index' (ANI) has been developed to evaluate the parasympathetic component of the nervous autonomous system. The aim of this study was to evaluate the ability of ANI to predict the risk of hypotension after SA for elective caesarean section. One hundred patients scheduled for elective caesarean delivery under SA were recruited in this observational prospective study. Hemodynamic and ANI parameters were recorded in supine position (TB), in sitting position (T0), after induction of SA (T1) and then every three minutes (T2, T3, Tn) until the end of surgery or having resort to ephedrine. After SA, women were classified into two groups according to occurrence of hypotension (group H, n = 80) or not (group C, n = 20). The variations of ANI between T2 and T0 were significantly higher in the group H as compared to the control group. A threshold of 4.5 points decrease in instantaneous ANI value could predict maternal hypotension. ANI is a simple and effective tool in predicting the risk of SA-related hypotension.Impact statementWhat is ...Continue Reading

References

Jul 1, 1997·Obstetrics and Gynecology·M D MuellerK P Lüscher
Jan 1, 1996·International Journal of Obstetric Anesthesia·S M Kinsella, M C Norris
Nov 25, 2004·Anesthesia and Analgesia·Dmitri ChamchadJ Yasha Kresh
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May 4, 2017·JAMA Surgery·Sandra I Berríos-TorresUNKNOWN Healthcare Infection Control Practices Advisory Committee

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