Zhou Zhou, Li Yujie, Zhu Jinxian, Liu Yingge, Wang Yuxin, Sang Xiaoqiao, Wang Xinxin, Zhang Xiaobao
Department of Anesthesiology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China.
Lianyungang Maternal and Child Health Hospital, Lianyungang, China.
BMC Anesthesiol. 2025 Feb 14;25(1):73. doi: 10.1186/s12871-025-02945-y.
Hypotension is a common side effect of propofol induction, and when severe, it is associated with adverse outcomes. Ultrasonography of the inferior vena cava (IVC) is a reliable indicator of the intravascular volume. This study investigated whether preoperative IVC ultrasound measurements could predict hypotension after propofol induction in patients undergoing colonoscopies.
Sixty-two adult patients with American Society of Anesthesiologists physical status (ASA) I-II scheduled for colonoscopy after propofol induction were recruited. The Ultrasound Maximum IVC diameter (dIVCmax), minimum IVC diameter (dIVCmin), and collapsibility index (IVC-CI) were assessed in all patients before propofol induction. Mean blood pressure (MBP) was recorded before induction. Propofol was injected intravenously after ultrasound measurements. MBP was recorded 1, 3, 5, and 10 min after propofol induction. The receiver operating characteristic (ROC) curve of IVC-CI was compared with that of patients who developed hypotension after propofol induction.
Sixty-two patients completed the study, and their data were considered for statistical analysis. After induction,30 patients developed hypotension. The area under the curve (95% confidence interval) was 0.72 (0.595 to 0.849) for IVC-CI. The optimal IVC-CI cutoff value was 38.25%, with a sensitivity of 56.7% and specificity of 71.9%. IVC-CI before induction strongly correlated with the maximum percentage of MBP drop after propofol induction. (regression coefficient = 0.33, P = 0.008), respectively.
Pre-induction IVC-CI > 38.25% is a non-invasive predictor of propofol-induced hypotension in patients undergoing colonoscopy and is strongly correlated with MBP drop.
This clinical trial was approved by the Ethics Committee of The Affiliated Lianyungang Hospital of Xuzhou Medical University (YJ-20190529001). All the study procedures were performed in accordance with the ethical standards of the Helsinki Declaration of 2013.
低血压是丙泊酚诱导麻醉的常见副作用，严重时会导致不良后果。下腔静脉超声检查是血管内容量的可靠指标。本研究旨在探讨术前下腔静脉超声测量能否预测结肠镜检查患者丙泊酚诱导麻醉后的低血压情况。
招募62例美国麻醉医师协会身体状况分级（ASA）为I-II级、计划在丙泊酚诱导麻醉后进行结肠镜检查的成年患者。在所有患者丙泊酚诱导麻醉前，评估下腔静脉最大直径（dIVCmax）、最小直径（dIVCmin）和塌陷指数（IVC-CI）。记录诱导麻醉前的平均血压（MBP）。超声测量后静脉注射丙泊酚。在丙泊酚诱导麻醉后1、3、5和10分钟记录MBP。将IVC-CI的受试者工作特征（ROC）曲线与丙泊酚诱导麻醉后发生低血压的患者的曲线进行比较。
62例患者完成研究，其数据用于统计分析。诱导麻醉后，30例患者出现低血压。IVC-CI的曲线下面积（95%置信区间）为0.72（0.595至0.849）。IVC-CI的最佳截断值为38.25%，敏感性为56.7%，特异性为71.9%。诱导麻醉前的IVC-CI与丙泊酚诱导麻醉后MBP下降的最大百分比密切相关（回归系数=0.33，P=0.008）。
诱导麻醉前IVC-CI>38.25%是结肠镜检查患者丙泊酚诱导低血压的无创预测指标，且与MBP下降密切相关。
本临床试验经徐州医科大学附属连云港医院伦理委员会批准（YJ-20190529001）。所有研究程序均按照2013年《赫尔辛基宣言》的伦理标准进行。
