Is the Perfusion Index Useful in Early Detection of High Spinal Subarachnoid Block during Cesarean Section?

OBJECTIVE: To investigate the usefulness of the perfusion index (PI) in the early detection of high spinal subarachnoid block (SAB) for cesarean section (CS).

METHOD: SAB was applied in patients of CS. The patients was subdivided into two groups, according to the highest level of block: the Ce group (cervical spine level) and the Th group (thoracic spine level). The PI values in the finger and toe, and vital signs were measured at pre- and post-SAB in both groups together with SAB level.

RESULTS: The PI valuses in the finger and toe were elevated post-SAB in both groups; it showed no significant difference between them. However, in the Ce group, anesthesia immediately reached the upper thoracic nerves, and blood pressure showed a significant decrease post-SAB.

CONCLUSIONS: Post-SAB finger PI value measuerments may not be useful for early detection of high SAB. Alternatively, the anesthesiologist should pay attention to immediate post-SAB changes in clinical signs such as a decrease in blood pressure as well as a rapid elevation of block level.