Evaluation of Inferior Vena Cava Collapsibility Index as a Predictor of Hypotension Following General Anaesthesia with Thiopentone Induction: An Observational Study

Abstract

Introduction: Hypotension during surgery can significantly increase morbidity and mortality. Volume depletion poses a major risk for intraoperative hypotension. The role of the Inferior Vena Cava Collapsibility Index (IVCCI) in assessing volume status is crucial, but its utility in predicting hypotension after the induction of general anaesthesia has been less evaluated. Aim: To evaluate the usefulness of IVCCI in predicting postinduction hypotension after general anaesthesia, with the primary objective being to assess the correlation between IVCCI and hypotension. Materials and Methods: An observational study was conducted in the Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma, PGIMS, Rohtak, Haryana,India. Total 100 patients scheduled for elective surgery under general anaesthesia with thiopentone induction. IVCCI was measured preoperatively in spontaneously breathing patients. The patients were grouped into CI+ (Collapsible) and CI- (Non collapsible) groups based on IVCCI values of ≥ 50% and ≤ 50%, respectively. Haemodynamic parameters were recorded for up to one hour after anaesthesia induction. Hypotension was defined as a fall of more than 20% in Systolic Blood Pressure (SBP) or SBP 38, as determined by performing multivariate logistic regression. Conclusion: Preoperative assessment of IVCCI is highly sensitive and specific for prediction hypotension induced by general anaesthesia. It is recommended as a screening tool for high-risk patients.

Keywords

• dynamic indices
• intravascular volume
• ultrasound