To Study The Correlation Between Preoperative Inferior Vena Cava Diameter And Intraoperative Hypotension During Spinal Anaesthesia In Caesarean Section.

Indian Journal of Applied Basic Medical Sciences
Year: 2021, Volume: 23(A), Issue. (1)
First page: (29) Last page: (37)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi: 10.48165/ijabms.2021.23104

To Study The Correlation Between Preoperative Inferior Vena Cava Diameter and Intraoperative Hypotension During Spinal Anaesthesia In Caesarean Section.
Pankti A. Panchal¹, Pancham H. Mehta^2* and Kamla H. Mehta^3
12^nd year resident, ²3^rd year resident, ³Professor, Department of Anesthesiology, Smt. SCL Hospital, Smt.NHL Municipal medical college, Ahmadabad.
Corresponding Author: Pankti A. Panchal, Email:  papanchal141994@gmail.com

Online Published on 02-February-2021

ABSTRACT

BACKGROUND: Assessment of maternal intravascular volume status during and after gestation is most crucial in the setting of complications that affect hemodynamic stability. The goal of the perioperative fluid management is to avoid acute kidney injury due to hypovolemia and hypotension due to spinal anaesthesia. Ultrasound measurements of dynamic change in inferior vena cava diameter (IVC) and collapsibility index are used to predict and prevent the hypotension after spinal anaesthesia.OBJECTIVES: To correlate the IVC diameter in expiration and incidences of intraoperative hypotension after spinal anaesthesia in full term pregnant patients posted for elective caesarean section.MATERIALS AND METHOD: Total 50 young female patients having full term pregnancy scheduled for elective caesarean sections were included in the study after taking informed consent. Preoperative assessment of all patients was done. Preoperative inferior vena cave diameter in expiration was measured by ultrasound guidance by subcostal approach. Spinal anaesthesia was given with injection bupivacaine heavy 0.5% 2ml between L3-L4 subarachnoid space after taking all aseptic precaution. Pulse, blood pressure was measured at regular interval. Incidence of intraoperative hypotension, bradycardia was noted. Results were expressed as mean ±SD and analysed by paired’ test and correlation coefficient was calculated.RESULTS: The mean inferior vena cava diameter in expiration was 17.4 ± 0.04 and collapsibility index was less than 36 in 80% of patients, and only one patient had developed hypotension after spinal anaesthesia. Correlation coefficient was -0.9.CONCLUSION: Preoperative inferior vena cava measurement is a reliable predictor of hypotension after spinal anaesthesia.

Keywords

Ultrasound, IVC collapsibility index, pregnant patients, spinal anaesthesia