Preoperative perfusion index as a predictor of post-anaesthetic shivering in caesarean section with spinal anaesthesia

Abstract

Background Post-anaesthetic shivering is frequently preceded by a decrease in peripheral blood flow. Perfusion index is a fast non-invasive method to assess peripheral blood flow, thus might be correlated with post-anaesthetic shivering. Aim To analyse the relationship between preoperative perfusion index and post-anaesthetic shivering in patients undergoing caesarean section with spinal anaesthesia. Methods In this prospective observational study, preoperative perfusion index measurements were performed on 40 participants who were undergoing elective caesarean section under spinal anaesthesia. Spinal anaesthesia was performed using Lidodex (Lignocaine + Dextrose 5%) at vertebrae L4–L5 or L3–L4 interspace. Shivering was observed until 120 minutes according to the Crossley and Mahajan scale. Statistical analysis was performed to examine the correlation and cut-off of preoperative perfusion index as a predictor for post-anaesthetic shivering. Result There was a significant relationship between preoperative perfusion index with the incidence ( p = 0.005) and the degree ( p = 0.014) of post-anaesthetic shivering. The preoperative perfusion index cut-off value based on the ROC curve was 4.2 (AUC = 0.762, p = 0.002) with a sensitivity of 73.9% and specificity of 88.2%. Participants with preoperative PI < 4.2 had a greater risk of post-anaesthetic shivering ( p < 0.001, RR = 3.13). Conclusion Preoperative perfusion index less than 4.2 can predict post-anaesthetic shivering in patients undergoing caesarean section with spinal anaesthesia.