Efficacy of the inferior vena cava collapsibility index in predicting anaesthesia-induced hypotension in elderly patients undergoing hip arthroplasty

被引：0
作者：
Yang Liu [1 ]
Yiwei Zhang [2 ]
Aizhong Wang [2 ]
Xinyue Xu [2 ]
Qian Ding [2 ]
Yang Xu [2 ]
Huiying Dong [2 ]
机构：
[1] Department of Anaesthesiology, Hainan Hospital of Chinese PLA General Hospital, Hainan, Sanya
[2] Department of Anaesthesiology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai
[3] Department of Human Resources, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai
来源：
Scientific Reports | / 14卷 / 1期
关键词：
Elderly patients; General anaesthesia; Hypotension; Inferior vena cava collapsibility index; Nerve block; Ultrasound;
D O I：
10.1038/s41598-024-78718-3
中图分类号：
学科分类号：
摘要：
The inferior vena cava collapsibility index (IVCCI) has been used to predict fluid responsiveness. This study aimed to evaluate the accuracy of the perioperative IVCCI to predict postinduction hypotension (PIH) under general anaesthesia (GA) combined with lumbar plexus sacral plexus block (LSPB) in elderly patients undergoing hip arthroplasty. A total of forty patients aged over 65 years were recruited for this prospective observational study. The diameters of the inferior vena cava (IVC), common iliac vein (CIV) and IVCCI were measured at baseline and 15 min post-LSPB. PIH was defined as a systolic blood pressure less than 90 mmHg or a ≥ 30% drop from baseline; patients were divided into hypotensive and nonhypotensive groups. The primary objective of this study was to evaluate the ability of the IVCCI to predict PIH via receiver operating characteristic (ROC) analysis. The secondary objective was to observe the change in CIV diameter. Eighteen patients (45%) developed PIH during GA. No statistically significant differences in baseline or post-LSPB IVCCI were detected between hypotensive and nonhypotensive patients (p > 0.05), whereas a significant expansion of the CIV (0.83 cm to 1.10 cm) was observed 15 min post-LSPB in all patients (p < 0.0001). According to the ROC curve analysis, the IVCCI cannot accurately predict severe PIH: the area under the ROC curve for the IVCCI was 0.54 (95% confidence interval: 0.35–0.72, P = 0.69). Thus, the IVCCI is not an effective predictor of PIH during GA combined with LSPB in elderly patients undergoing hip arthroplasty. Additionally, significant expansion of the CIV was observed 15 min after LSPB, indicating sympathetic blockade of the unilateral lower extremity. © The Author(s) 2024.
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  • [31] Singer M., The FTc is not an accurate marker of left ventricular preload, Intensive Care Med, 32, (2006)
  • [32] Lipszyc A.C., Walker S.C.D., Beech A.P., Wilding H., Akhlaghi H., Predicting fluid responsiveness using carotid ultrasound in mechanically ventilated patients: A systematic review and meta-analysis of diagnostic test accuracy studies, Anesth. Analg, 138, pp. 1174-1186, (2024)
  • [33] Mak J.C., Cameron I.D., March L.M., Evidence-based guidelines for the management of hip fractures in older persons: an update, Med. J. Aust, 192, pp. 37-41, (2010)
  • [34] Liu S.S., McDonald S.B., Current issues in spinal anesthesia, Anesthesiology, 94, pp. 888-906, (2001)
  • [35] Chen L., Liu J., Yang J., Zhang Y., Liu Y., Combined fascia iliaca and sciatic nerve block for hip surgery in the presence of severe ankylosing spondylitis: A case-based literature review, Reg. Anesth. Pain Med, 41, pp. 158-163, (2016)
  • [36] Tulgar S., Aydin M.E., Ahiskalioglu A., De Cassai A., Gurkan Y., Anesthetic techniques: Focus on lumbar erector spinae plane block, Local Reg. Anesth, 13, pp. 121-133, (2020)
  • [37] Bendtsen T.F., Et al., Anatomical considerations for obturator nerve block with fascia iliaca compartment block, Reg. Anesth. Pain Med, 46, pp. 806-812, (2021)
  • [38] Zheng J., Pan D., Zheng B., Ruan X., Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: A randomized, placebo-controlled trial, Reg. Anesth. Pain Med, 47, pp. 155-160, (2022)
  • [39] Xu Y., Et al., Blood flow changes in the forearm arteries after ultrasound-guided costoclavicular brachial plexus blocks: A prospective observational study, BMC Anesthesiol, 21, (2021)
  • [40] Lange K.H., Et al., Skin temperature measured by infrared thermography after specific ultrasound-guided blocking of the musculocutaneous, radial, ulnar, and median nerves in the upper extremity, Br. J. Anaesth, 106, pp. 887-895, (2011)
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