Preoperative inferior vena cava ultrasonography can predict post-induction hypotension in patients undergoing gastrointestinal surgery

Abstract

Purpose: In this study we aimed to evaluate effectiveness of preoperative IVC ultrasonography in predicting hypotension which develops following anesthesia induction, and in determining hypovolemia occurring in patients undergoing bowel preparation as secondary outcomes. Materials and Methods: The study included patients with American Society of Anesthesiologists physical status classification (ASA) I-II, aged between 18 and 65 years who were scheduled for gastrointestinal operation under general anesthesia. Fourty-two of the 84 patients included underwent bowel preparation. Patients’ maximum diameter of inferior vena cava (dIVCmax) and minimum diameter of inferior vena cava (dIVCmin), inferior vena cava collapsibility index (IVC-CI) and preinduction basal mean arterial pressure (MAP) was measured. Results: Thirty-nine (46.4%) of the 84 patients developed hypotension after general anesthesia induction. Cut-off for dIVCmax was found as 15.750 mm with ROC analysis. Specificity and sensitivity for the cut-off value of 15.750 mm were calculated as 55.6% and 71.8%, respectively. Cut-off for IVC-CI was found as 32.746 % with ROC analysis. Specificity and sensitivity for the cut-off value of 32.746 % mm were calculated as 83.3% and 74.4%, respectively. Conclusion: According to our data, IVC ultrasonography may be helpful in prediction of preoperative hypovolemia in patients. IVC-CI was higher and dIVCmax was lower and the incidence of hypotension was higher in patients who underwent bowel preparation compared to the patient who did not undergo.

Keywords

• hypotension
• hypovolemia
• ultrasonography
• vena cava inferior
• anesthesia
• colorectal surgery
• propofol