Ultrasound Guided Assessment of Inferior Vena Cava Collapsibility Index and Fluid Optimization to Minimize the Spinal Induced Hypotension in Patients Undergoing Femur Fracture Surgeries
Authors/Creators
- 1. PG Student, Department of Anaesthesiology and Critical Care, Dr S.N. Medical College and Associated Hospitals, Jodhpur
- 2. M.D. Anaesthesiology, Senior Professor, Department of Anaesthesiology and Critical Care, Dr S.N. Medical College and Associated Hospitals, Jodhpur
- 3. M.D. Anaesthesiology, Assistant Professor, Department of Anaesthesiology and Critical Care, Dr S.N. Medical College and Associated Hospitals, Jodhpur
- 4. PG student, Department of Anaesthesiology and Critical Care, Dr S.N. Medical College and Associated Hospitals, Jodhpur
Description
Hypotension is the most common side effect of spinal anaesthesia. Ultrasonography (USG) being the most reliable diagnostic technique for examination of the inferior vena cava (IVC) and inferior vena cava collapsibility index (IVCCI) in order to estimate the volume status in patients with spontaneous respiration. The aim of present study was to find out ultrasound guided inferior vena cava collapsibility index and fluid optimization to minimize the incidence of spinal induced hypotension in patients undergoing femur fracture surgeries. The study was enrolled as prospective, interventional trial which included 80 patients of American society of Anaesthesiologists grade I and II scheduled for femur fracture surgeries. Eighty patients were divided into 2 groups- case group (IVC group) and control group with 40 patients in each group. In case group IVC ultrasound guided fluid optimization before spinal anaesthesia and in control group, there was no IVC ultrasound assessment. The primary outcome of the study was incidence of spinal induced hypotension (SIH) between the two groups. The secondary outcomes were correlation of collapsibility index with mean arterial blood pressure and pre-spinal fluid, requirement of vasopressor drugs in both groups, changes in haemodynamic parameters after spinal anaesthesia in both groups. The incidence of hypotension after spinal anaesthesia was lower in case group (15%) as compared to control group (42.5%). There was decreased requirement of vasopressors in case group as compared to control group. IVC guided fluid optimization reduces spinal induced hypotension and requirement of vasopressors in patients posted for femur fracture surgeries. Total IV fluid given was more in case group as compared to control group.
Abstract (English)
Hypotension is the most common side effect of spinal anaesthesia. Ultrasonography (USG) being the most reliable diagnostic technique for examination of the inferior vena cava (IVC) and inferior vena cava collapsibility index (IVCCI) in order to estimate the volume status in patients with spontaneous respiration. The aim of present study was to find out ultrasound guided inferior vena cava collapsibility index and fluid optimization to minimize the incidence of spinal induced hypotension in patients undergoing femur fracture surgeries. The study was enrolled as prospective, interventional trial which included 80 patients of American society of Anaesthesiologists grade I and II scheduled for femur fracture surgeries. Eighty patients were divided into 2 groups- case group (IVC group) and control group with 40 patients in each group. In case group IVC ultrasound guided fluid optimization before spinal anaesthesia and in control group, there was no IVC ultrasound assessment. The primary outcome of the study was incidence of spinal induced hypotension (SIH) between the two groups. The secondary outcomes were correlation of collapsibility index with mean arterial blood pressure and pre-spinal fluid, requirement of vasopressor drugs in both groups, changes in haemodynamic parameters after spinal anaesthesia in both groups. The incidence of hypotension after spinal anaesthesia was lower in case group (15%) as compared to control group (42.5%). There was decreased requirement of vasopressors in case group as compared to control group. IVC guided fluid optimization reduces spinal induced hypotension and requirement of vasopressors in patients posted for femur fracture surgeries. Total IV fluid given was more in case group as compared to control group.
Files
IJPCR,Vol15,Issue11,Article213.pdf
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Additional details
Dates
- Accepted
-
2023-11-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue11,Article213.pdf
- Development Status
- Active
References
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