Pre-anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly: A prospective observational study
Background Increased age has been linked to the development of spinal anaesthesia induced hypotension (SAIH) and increased the risk of perioperative complications. The internal jugular vein collapsibility index (IJV-CI), rates of change in IJV diameter (ΔIJV-D) and IJV area (ΔIJV-A) in the supine an...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2082051 |
| _version_ | 1828777623103209472 |
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| author | Bassant M. Abdelhamid Abeer Ahmed Mai Ramzy Ashraf Rady Haitham Hassan |
| author_facet | Bassant M. Abdelhamid Abeer Ahmed Mai Ramzy Ashraf Rady Haitham Hassan |
| author_sort | Bassant M. Abdelhamid |
| collection | DOAJ |
| description | Background Increased age has been linked to the development of spinal anaesthesia induced hypotension (SAIH) and increased the risk of perioperative complications. The internal jugular vein collapsibility index (IJV-CI), rates of change in IJV diameter (ΔIJV-D) and IJV area (ΔIJV-A) in the supine and Trendelenburg positions, and carotid intima-media thickness (CIMT) were evaluated as predictors of SAIH in the senior population.Materials and methods This prospective Cohort was conducted at the Cairo University Hospitals. Seventy-one patients scheduled for elective procedures under spinal anaesthesia of ASA I–III, over 60 years and BMI less than 30 kg/m2. The right IJV was assessed ultrasonographically in supine and Trendelenburg postures, as well as CIMT. The primary outcome was the IJV- CI as predictor of SAIH while ΔIJV-D and ΔIJV-A with posture and CIMT in prediction of SAIH were assigned as secondary outcomes.Results SAIH was shown in forty-seven (66.2%) of patients. IJV-CI, ΔIJV-A and ΔIJV-D increased significantly in Hypotensive group (median 38.09, IQR (23.61–50), 0.393 (0.2–0.52) and 0.213 (0.12–0.34) respectively) in comparison to Non-hypotensive group (26.05 (10.32–34.08), 0.167 (0.03–0.48) and 0.074 (0.02–0.29) respectively) (p-value <0.05). IJV-CI showed AUROC of 0.699 and 95% CI of 0.578–0.802 (p-value = 0.002) with cut-off value ≥0.34.4, 61.70% sensitivity, 79.17% specificity, 85.3% PPV and 51.4% NPV.Conclusions Preanesthetic IJV-CI and ΔIJV-D from the supine to the Trendelenburg position were moderate predictors of SAIH. Results suggested that IJV-CI is > 34.4% and a ΔIJV-D is of ≥ 0.11 to be the threshold levels, while CMIT could not predict SAIH. |
| first_indexed | 2024-12-11T16:25:55Z |
| format | Article |
| id | doaj.art-ba6436bf6db240d38fc4d1fccb223c1d |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-12-11T16:25:55Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-ba6436bf6db240d38fc4d1fccb223c1d2022-12-22T00:58:45ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492022-12-0138134935610.1080/11101849.2022.2082051Pre-anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly: A prospective observational studyBassant M. Abdelhamid0Abeer Ahmed1Mai Ramzy2Ashraf Rady3Haitham Hassan4Faculty of Medicine, Cairo UniversityDepartment of Anaesthesiology, Surgical ICU and Pain Management, Kasr-Alainy, Giza, EgyptFaculty of Medicine, Cairo UniversityDepartment of Anaesthesiology, Surgical ICU and Pain Management, Kasr-Alainy, Giza, EgyptFaculty of Medicine, Cairo UniversityDepartment of Anaesthesiology, Surgical ICU and Pain Management, Kasr-Alainy, Giza, EgyptFaculty of Medicine, Cairo UniversityDepartment of Anaesthesiology, Surgical ICU and Pain Management, Kasr-Alainy, Giza, EgyptFaculty of Medicine, Cairo UniversityDepartment of Anaesthesiology, Surgical ICU and Pain Management, Kasr-Alainy, Giza, EgyptBackground Increased age has been linked to the development of spinal anaesthesia induced hypotension (SAIH) and increased the risk of perioperative complications. The internal jugular vein collapsibility index (IJV-CI), rates of change in IJV diameter (ΔIJV-D) and IJV area (ΔIJV-A) in the supine and Trendelenburg positions, and carotid intima-media thickness (CIMT) were evaluated as predictors of SAIH in the senior population.Materials and methods This prospective Cohort was conducted at the Cairo University Hospitals. Seventy-one patients scheduled for elective procedures under spinal anaesthesia of ASA I–III, over 60 years and BMI less than 30 kg/m2. The right IJV was assessed ultrasonographically in supine and Trendelenburg postures, as well as CIMT. The primary outcome was the IJV- CI as predictor of SAIH while ΔIJV-D and ΔIJV-A with posture and CIMT in prediction of SAIH were assigned as secondary outcomes.Results SAIH was shown in forty-seven (66.2%) of patients. IJV-CI, ΔIJV-A and ΔIJV-D increased significantly in Hypotensive group (median 38.09, IQR (23.61–50), 0.393 (0.2–0.52) and 0.213 (0.12–0.34) respectively) in comparison to Non-hypotensive group (26.05 (10.32–34.08), 0.167 (0.03–0.48) and 0.074 (0.02–0.29) respectively) (p-value <0.05). IJV-CI showed AUROC of 0.699 and 95% CI of 0.578–0.802 (p-value = 0.002) with cut-off value ≥0.34.4, 61.70% sensitivity, 79.17% specificity, 85.3% PPV and 51.4% NPV.Conclusions Preanesthetic IJV-CI and ΔIJV-D from the supine to the Trendelenburg position were moderate predictors of SAIH. Results suggested that IJV-CI is > 34.4% and a ΔIJV-D is of ≥ 0.11 to be the threshold levels, while CMIT could not predict SAIH.https://www.tandfonline.com/doi/10.1080/11101849.2022.2082051Spinal anaesthesia induced hypotensioninternal jugular vein collapsibility indexIJV diameterIJA arearates of change in IJV diameter with posturerates of change in IJV area with posture |
| spellingShingle | Bassant M. Abdelhamid Abeer Ahmed Mai Ramzy Ashraf Rady Haitham Hassan Pre-anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly: A prospective observational study Egyptian Journal of Anaesthesia Spinal anaesthesia induced hypotension internal jugular vein collapsibility index IJV diameter IJA area rates of change in IJV diameter with posture rates of change in IJV area with posture |
| title | Pre-anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly: A prospective observational study |
| title_full | Pre-anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly: A prospective observational study |
| title_fullStr | Pre-anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly: A prospective observational study |
| title_full_unstemmed | Pre-anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly: A prospective observational study |
| title_short | Pre-anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly: A prospective observational study |
| title_sort | pre anaesthetic ultrasonographic assessment of neck vessels as predictors of spinal anaesthesia induced hypotension in the elderly a prospective observational study |
| topic | Spinal anaesthesia induced hypotension internal jugular vein collapsibility index IJV diameter IJA area rates of change in IJV diameter with posture rates of change in IJV area with posture |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2082051 |
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