All India Institute of Medical Sciences (AIIMS), Department of Anaesthesiology & Critical Care, Jodhpur, India.
All India Institute of Medical Sciences (AIIMS), Department of Anaesthesiology & Critical Care, Jodhpur, India.
Braz J Anesthesiol. 2023 Jul-Aug;73(4):385-392. doi: 10.1016/j.bjane.2022.04.001. Epub 2022 Apr 14.
Post-spinal anesthesia hypotension is of common occurrence, and it hampers tissue perfusion. Several preoperative factors determine patient susceptibility to hypotension. This study aimed to assess the effectiveness of the Inferior Vena Cava Collapsibility Index (IVCCI) for predicting intraoperative hypotension.
One hundred twenty-nine adult patients who were scheduled for elective surgical procedures after administration of spinal (intrathecal) anesthesia were included in the study. Ultrasound evaluation of the Inferior Vena Cava (IVC) was done in the preoperative area, and the patients were shifted to the Operating Room (OR) for spinal anesthesia. An independent observer recorded the change in blood pressure after spinal anesthesia inside the OR.
Twenty-five patients developed hypotension (19.37%). Baseline systolic blood pressure and mean blood pressures were statistically higher in those patients who developed hypotension (p = 0.001). The logistic regression analysis for IVCCI and the incidence of hypotension showed r of 0.025. Receiver Operating Characteristic (ROC) curve analysis demonstrated the Area Under the Curve (AUC) of 0.467 (95% Confidence Interval, 0.338 to 0.597; p = 0.615).
Preoperative evaluation of IVCCI is not a good predictor for the occurrence of hypotension after spinal anesthesia.
椎管麻醉后低血压很常见，会妨碍组织灌注。一些术前因素决定了患者对低血压的易感性。本研究旨在评估下腔静脉塌陷指数（IVCCI）预测术中低血压的效果。
本研究纳入了 129 名接受椎管内麻醉后择期手术的成年患者。在术前区域对下腔静脉（IVC）进行超声评估，然后将患者转移到手术室（OR）进行椎管麻醉。一位独立观察者记录 OR 内椎管麻醉后血压的变化。
25 名患者发生低血压（19.37%）。发生低血压的患者的基础收缩压和平均血压均有统计学差异（p=0.001）。IVCCI 与低血压发生率的逻辑回归分析显示 r 为 0.025。受试者工作特征（ROC）曲线分析显示曲线下面积（AUC）为 0.467（95%置信区间，0.338 至 0.597；p=0.615）。
术前 IVCCI 评估不能很好地预测椎管麻醉后低血压的发生。
