The influence of inferior vena cava compression on the level of spinal anesthesia

Background: Spinal anesthesia has become an alternative to general anesthesia. However, spinal anesthesia has the most common side effects including, bradycardia and hypotension. The aim of this study was to determine the relationship between changes in the inferior vena cava index (delta inferior vena cava index) to changes in mean arterial pressure in spinal anesthesia. Methods: This study was an observational pre-post test study in thirty-two patients who received spinal anesthesia. The inferior vena cava index (inferior vena cava collectibility index and caval-aorta index) was measured before and after spinal anesthesia (5 and 10 minutes after onset). Data were analyzed using the Kolmogorov Smirnov test, Shapiro-Wilk test, T-test, and correlation test with α=5% Result: There was a significant difference in mean arterial pressure (MAP), delta inferior vena cava collectibility index (D-IVC-CI), and delta caval-aorta index (D-CAo-I) before and after spinal anesthesia. D-IVC-CI and D-CAo-I are significantly correlated with MAP. The correlation between D-IVC-CI and MAP had R = -0.371 (P <0.05) at 5 minutes post-anesthesia, while D-CAo-I and MAP had R = 0.472 (P <0.05) at 10 minutes post-anesthesia. Conclusion: The delta inferior vena cava index is correlated with the mean arterial pressure (MAP) value in spinal anesthesia.

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THE INFLUENCE OF INFERIOR VENA CAVA COMPRESSION ON THE LEVEL OF SPINAL ANESTHESIA

Survey of Anesthesiology ◽

10.1097/00132586-196908000-00038 ◽

1969 ◽

Vol 13 (4) ◽

pp. 386???387

Author(s):

D. L. BARCLAY ◽

O. J. RENEGAR ◽

E. W. NELSON ◽

Gordon M. Wyant

Keyword(s):

Inferior Vena Cava ◽

Spinal Anesthesia ◽

Inferior Vena ◽

Vena Cava

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The relationship between collapsibility index of inferior vena cava and hypotension after spinal anesthesia

The European Research Journal ◽

10.18621/eurj.739559 ◽

2021 ◽

Author(s):

Serra TOPAL ◽

Derya KARASU ◽

Canan YILMAZ ◽

Çağdaş BAYTAR ◽

Erhan TENEKECİOĞLU ◽

...

Keyword(s):

Inferior Vena Cava ◽

Spinal Anesthesia ◽

Inferior Vena ◽

Vena Cava ◽

Collapsibility Index ◽

The Relationship

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Preanesthetic Ultrasonography Assessment of Inferior Vena Cava Diameter in the Supine Position, Left Lateral Tilt Position, and with the Left Uterine Displacement Maneuver in Full-Term Pregnant Women: A Randomized Cross-Over Design Study

10.21203/rs.3.rs-817625/v1 ◽

2021 ◽

Author(s):

Tomonori Furuya ◽

Noriya Hirose ◽

Hanae Sato ◽

Risa Niikura ◽

Miho Kijima ◽

...

Keyword(s):

Inferior Vena Cava ◽

Pregnant Women ◽

Spinal Anesthesia ◽

Supine Position ◽

Inferior Vena ◽

Vena Cava ◽

Full Term ◽

Hemodynamic Parameters ◽

Lateral Tilt ◽

Inferior Vena Cava Diameter

Abstract BackgroundWe used preanesthetic ultrasonography evaluation to study the effectiveness of left lateral tilt position (LLT) and the left uterine displacement maneuver (LUD) on increasing inferior vena cava diameter (IVCD) in healthy full-term pregnant women, using a randomized, single blinded, cross-over design study.MethodsTwenty-two parturients scheduled for elective cesarean section under spinal anesthesia were recruited. All patients were sequentially placed in the supine position (SPN), LLT and with LUD before induction of spinal anesthesia. Indices of IVCD, measured by subxiphoid ultrasonography, including maximum IVCD (IVCDmax), minimum IVCD (IVCDmin) and collapsibility index (CI), and hemodynamic parameters, such as heart rate and blood pressure, were recorded in each of the postures. Mean or median values of all measurements were compared among the postures.ResultsThe mean values of IVCDmax observed with both LLT and LUD were significantly larger than those in the SPN, respectively (SPN vs. LLT: P <0.05, SPN vs. LUD: P <0.01), although there were no significant differences between IVCDmax with LLT and LUD. There were no significant differences in IVCDmin, CI and hemodynamic parameters between any of the postures. IVCDmax was highest with LUD in 11 patients (55%), in the LLT position in seven patients (35%) and in the SPN in two patients (10%).ConclusionsLLT and LUD might be equally effective in enlarging the narrowed IVCD as compared to SPN. However, both LLT and LUD might not necessarily be appropriate treatment to relieve IVC compression in some cases.Trial registrationThis study was registered in the “UMIN Clinical Trials Registry” (ID no.: 000024344, date. 10th October 2016).

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Inferior Vena Cava Ultrasound-guided fluid administration prior to spinal anesthesia reduced the rate of post-procedural hypotension. A randomized controlled trial

10.26226/morressier.5fa2cf404d4e91fe5c54b844 ◽

2020 ◽

Author(s):

Samuele Ceruti ◽

Mathieu Favre ◽

Maira Biggiogero ◽

Michele Musiari ◽

Andrea Glotta ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Inferior Vena Cava ◽

Spinal Anesthesia ◽

Inferior Vena ◽

Controlled Trial ◽

Vena Cava ◽

Fluid Administration ◽

Ultrasound Guided ◽

Randomized Controlled

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Measurements of Inferior Vena Cava Diameter for Prediction of Hypotension and Bradycardia during Spinal Anesthesia in Spontaneously Breathing Patients during Elective Knee Joint Replacement Surgery

Medicina ◽

10.3390/medicina54030049 ◽

2018 ◽

Vol 54 (3) ◽

pp. 49 ◽

Cited By ~ 2

Author(s):

Asta Mačiulienė ◽

Arūnas Gelmanas ◽

Inna Jaremko ◽

Ramūnas Tamošiūnas ◽

Alfredas Smailys ◽

...

Keyword(s):

Inferior Vena Cava ◽

Knee Joint ◽

Spinal Anesthesia ◽

Joint Replacement ◽

Inferior Vena ◽

Vena Cava ◽

Knee Joint Replacement ◽

Joint Replacement Surgery ◽

Replacement Surgery ◽

Spontaneously Breathing

Background and objective: Hypotension and bradycardia are the most common hemodynamic disorders and side effects of spinal anesthesia (SA) on the cardiovascular system. SA-induced sympathetic denervation causes peripheral vasodilatation and redistribution of central blood volume that may lead to decreased venous return to the heart. The aim of the study was to evaluate the changes of inferior vena cava collapsibility index (IVC-CI) during SA in spontaneously breathing patients during elective knee joint replacement surgery to prognose manifestation of intraoperative hypotension and bradycardia. Materials and methods: 60 patients (American Society of Anesthesiologists (ASA) physical status I or II, no clinically significant cardiovascular pathology) of both sexes undergoing elective knee joint replacement surgery under SA were included in the prospective study. Inspiratory and expiratory inferior vena cava (IVCin, IVCex) diameters were measured using an ultrasound device in supine position before and immediately after SA, then 15 min, 30 min, and 45 min after SA was performed. The heart rate, along with systolic, diastolic, and mean arterial blood pressures were collected. The parameters were measured at the baseline and at the next four time points. Results: There were no significant changes in IVCin, IVCex, and IVC-CI compared to baseline and other time point measurements in hypotensive versus nonhypotensive and bradycardic versus nonbradycardic patients (p > 0.05). Changes in IVC diameter do not prognose hypotension and/or bradycardia during SA: the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for IVC-CI at all measuring points was <0.7, p > 0.05. Conclusions: Reduction in IVC diameters and increase in IVC-CI do not predict hypotension and bradycardia during SA in spontaneously breathing patients undergoing elective knee joint replacement surgery.

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Fluid administration guided by inferior vena cava ultrasound before spinal anaesthesia may reduce post procedural hypotension rate

10.1101/2021.06.20.21258944 ◽

2021 ◽

Author(s):

Mathieu Favre ◽

Samuele Ceruti ◽

Maira Biggiogero ◽

Michele Musiari ◽

Andrea Glotta ◽

...

Keyword(s):

Inferior Vena Cava ◽

Arterial Pressure ◽

Spinal Anesthesia ◽

Inferior Vena ◽

Reduction Rate ◽

Vena Cava ◽

Clinical Signs ◽

Test Group ◽

Control Group ◽

Group I

PURPOSE: This study was conducted to estimate the incidence of hypotension after spinal anesthesia after inferior vena cava ultrasound (IVCUS) guided volaemic optimization compared with a control group in patients undergoing elective surgery. According to ESICM guidelines, hypotension was defined as two systolic arterial pressure (SAP) measurements < 80 mmHg and / or a mean arterial pressure (MAP) < 60 mmHg, or a drop in SAP of more than 50 mmHg or more than 25% from baseline, or a decrease in MAP by more than 30% from baseline and / or clinical signs/symptoms of inadequate perfusion. MATERIALS AND METHODS: From May 2014 to February 2019, a prospective, controlled, randomised, three-arm, parallel-group trial was performed in our tertiary hospital. In the IVCUS group (I, 132 patients) and passive leg raising test group (L, 148 patients), a pre-anaesthesia volume optimization was achieved following a fluid response protocol. In control group (C, 149 patients), no specific intervention was performed. RESULTS: 474 patients were collected. In group I, hypotension rate was 35%. In group L hypotension rate was 44%. In group C hypotension rate was 46%. An 11% reduction rate in hypotension (95% CI -1 to -24%, P=0.047) was observed between the group I and the group C. A 2% reduction rate in hypotension (95% CI -3 to -5%, P=0.428) was observed between group L and the group C. Total fluid amount administered was greater in the I group I than in the group C (593 ml versus 453 ml, P=0.015) and greater in the group L than the group C (511 ml versus 453 ml, P=0.11). CONCLUSION: IVCUS guided fluid optimization decrease the incidence of arterial hypotension after spinal anesthesia.

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