Evaluating the efficacy of inferior vena cava collapsibility index and caval aorta index in anticipating the incidence of hypotension after spinal anaesthesia: A Clinical study

Abstract

Background
Spinal anesthesia is commonly used in various surgical procedures but is often associated with hypotension, which can lead to significant complications. The Inferior Vena Cava
Collapsibility Index (IVCCI) and Caval Aorta Index (CAI) are potential predictors of fluid
responsiveness and can help anticipate hypotension after spinal anesthesia. This study aims to evaluate the efficacy of IVCCI and CAI in predicting hypotension following spinal anesthesia.
Materials and Methods
A total of 100 patients scheduled for elective surgeries under spinal anesthesia were enrolled
in this prospective clinical study. Preoperative IVCCI and CAI measurements were obtained using ultrasound. Spinal anesthesia was administered using 0.5% bupivacaine. Blood pressure
was monitored every 5 minutes for 30 minutes post-anesthesia. Hypotension was defined as a
systolic blood pressure decrease of more than 20% from baseline or below 90 mmHg.
Statistical analysis was performed using logistic regression to assess the predictive value of
IVCCI and CAI for hypotension.
Results
Out of 100 patients, 35 developed hypotension after spinal anesthesia. The mean IVCCI for the
hypotensive group was 45%, compared to 25% in the non-hypotensive group (p < 0.01). The
mean CAI was 0.8 in the hypotensive group and 0.6 in the non-hypotensive group (p < 0.05).
Logistic regression analysis revealed that both IVCCI and CAI were significant predictors of
hypotension, with IVCCI having a higher predictive accuracy (AUC = 0.85) compared to CAI
(AUC = 0.78).
Conclusion
The Inferior Vena Cava Collapsibility Index and Caval Aorta Index are effective predictors of
hypotension following spinal anesthesia. IVCCI, in particular, demonstrates superior predictive  accuracy. Incorporating these indices into preoperative assessments may enhance the
management and prevention of hypotension, improving patient outcomes.