Publication: Ultrasonographic Evaluation of Inferior Vena Cava: Aorta Index with a Cut-off Value of 1.0 as a Predictor for Hypotension after Induction of General Anesthesia; An observational study
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Hypotension after induction of general anesthesia (GA) is common due to pre-existing
hypovolemia and has adverse effects on organ function. Out of several methods to
predict post-induction hypotension, nowadays Inferior Vena Cava: Aorta (IVC: Ao)
index has been studied with different cut-off values. However, limited studies have
been performed in our part of the world.
Objective
To evaluate the efficacy of pre-induction Inferior Vena Cava: Aorta index with a cut-
off value of 1.0 for predicting the occurrence of post-induction hypotension after
general anesthesia in the Nepalese population.
Method
A total of 100 patients of ASA I and II, aged more than 18 years posted for
elective surgeries under general anesthesia were enrolled in this cross-sectional,
observational study. Ultrasonographic guided Inferior Vena Cava: Aorta index was
calculated and based on a cut-off value of 1.0, two groups were formed. Seventy
patients in group A with Inferior Vena Cava: Aorta index less than 1.0 and 30 patients
in group B with Inferior Vena Cava: Aorta index more than 1.0 were enrolled. Vitals
parameters were recorded every minute for five minutes after induction of general
anesthesia. Incidence of hypotension was the primary outcome. Statistical analysis
was done using student t-test, ANOVA test and Chi-square test.
Result
Inferior Vena Cava: Aorta index with cut-off value of 1.0 predicted post-induction
hypotension with excellent efficacy. Total 65 patients developed post-induction
hypotension, out of which 63 patients had Inferior Vena Cava: Aorta index less than
1.0.
Conclusion
We concluded that pre-induction Inferior Vena Cava: Aorta index with cut-off value
of 1.0 have high diagnostic accuracy with high degree of sensitivity and specificity to
predict hypotension after induction of general anesthesia.
KEY WORDS
General Anesthesia, Hypotension, Hypovolemia, Inferior vena cava: Aorta index
Description
Shakya S, Shrestha B, Singh J, Ranjit S
Department of Anesthesiology
Dhulikhel Hospital, Kathmandu University Hospital
Kathmandu University School of Medical Sciences
Dhulikhel, Kavre, Nepal
Keywords
General Anesthesia, Hypotension, Hypovolemia, Inferior vena cava: Aorta index