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Preoperative ultrasound guided inferior venacava collapsibility index as a guide to predict hypotension following spinal anaesthesia in patients scheduled for elective surgery

Background: Spinal anaesthesia is the most commonly employed anaesthetic technique for infraumbilical surgeries. Post spinal hypotension is a commonly encountered complication which can lead to organ under perfusion and ischemia. Severe episodes of intraoperative hypotension have been proposed as an independent risk factorin the development of postoperative adverse outcomes and prolonged hospital stay. However, there are no reliable methods to determine which patients are at risk for spinal induced hypotension. This study investigated whether preoperative ultrasound guided inferior venacava collapsibility index (IVC-CI) could predict hypotension following spinal anaesthesia. Objectives were to measure inferior venacava collapsibility index and to compare the incidence of hypotension following spinal anaesthesia among patients with IVC-CI>50% and patients with IVC-CI<50%. Materials and Methods: This prospective observational study was conducted in the department of anaesthesia, Yenepoya Medical College Hospital, Mangalore during the period between October 2016 to October 2018. After ethical committee approval and informed consent, 73 patients belonging to “American society of Anesthesiology” (ASA) grade I & II, aged between 18 to 65 years, scheduled for elective surgeries which require spinal anaesthesia were selected. Preoperative ultrasonography was done to determine the IVC-CI in these patients. All ultrasonographic examinations were performed by the same anaesthesiologist. 