Pre-anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly: A prospective observational study

Autor: Bassant M. Abdelhamid, Abeer Ahmed, Mai Ramzy, Ashraf Rady, Haitham Hassan
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Egyptian Journal of Anaesthesia, Vol 38, Iss 1, Pp 349-356 (2022)
Druh dokumentu: article
ISSN: 11101849
1110-1849
DOI: 10.1080/11101849.2022.2082051
Popis: Background Increased age has been linked to the development of spinal anaesthesia induced hypotension (SAIH) and increased the risk of perioperative complications. The internal jugular vein collapsibility index (IJV-CI), rates of change in IJV diameter (ΔIJV-D) and IJV area (ΔIJV-A) in the supine and Trendelenburg positions, and carotid intima-media thickness (CIMT) were evaluated as predictors of SAIH in the senior population.Materials and methods This prospective Cohort was conducted at the Cairo University Hospitals. Seventy-one patients scheduled for elective procedures under spinal anaesthesia of ASA I–III, over 60 years and BMI less than 30 kg/m2. The right IJV was assessed ultrasonographically in supine and Trendelenburg postures, as well as CIMT. The primary outcome was the IJV- CI as predictor of SAIH while ΔIJV-D and ΔIJV-A with posture and CIMT in prediction of SAIH were assigned as secondary outcomes.Results SAIH was shown in forty-seven (66.2%) of patients. IJV-CI, ΔIJV-A and ΔIJV-D increased significantly in Hypotensive group (median 38.09, IQR (23.61–50), 0.393 (0.2–0.52) and 0.213 (0.12–0.34) respectively) in comparison to Non-hypotensive group (26.05 (10.32–34.08), 0.167 (0.03–0.48) and 0.074 (0.02–0.29) respectively) (p-value 34.4% and a ΔIJV-D is of ≥ 0.11 to be the threshold levels, while CMIT could not predict SAIH.
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