Caval aorta index as a predictor of hypotension after spinal anesthesia in patients with diabetes mellitus - A cross-sectional comparative study.

BACKGROUND AND AIMS: Postspinal hypotension (PSH) is a common adverse event following spinal anesthesia, with a pronounced incidence among diabetic individuals due to autonomic neuropathy. This study aimed to assess the caval aorta index (IVC/AO) and IVC collapsibility index (IVCCI) as predictors of PSH.

MATERIAL AND

METHODS

One hundred and twenty patients scheduled for elective surgeries under spinal anesthesia were divided into two groups: Group A (Diabetic) and Group B (nondiabetic). IVC and aorta diameters were measured to calculate the IVC/AO index and IVCCI. Patients in both groups received spinal anesthesia using 0.5% bupivacaine (3 ml). Hemodynamic parameters were recorded, and the incidence of PSH was noted. The odds ratio for PSH was ascertained between the groups, and correlations of age, body mass index, diabetes duration, and random blood glucose levels with the IVC/AO index were performed. Receiver operating characteristic curves were used to evaluate the diagnostic value of the IVC/AO index and IVCCI for predicting PSH. A P value of <0.05 was considered statistically significant.

RESULTS

PSH was observed in 82 patients (68%), with 58 in group A and 24 in group B. Diabetics had a lower IVC/AO index (P < 0.002) and a significantly elevated IVCCI (P < 0.001). The IVC/AO index of <1.065 indicated an increased odds ratio (5.5) for developing PSH. A strong negative correlation was noted between the duration of diabetes and IVC/AO index.

CONCLUSIONS

Preoperative ultrasonographic measurement of the IVC/AO and IVCCI indices is a useful predictors of PSH in diabetic patients.