Inferior vena cava ultrasound to guide fluid management for prevention of hypotension after spinal anesthesia in a tertiary level teaching hospital.

BACKGROUND

Hypotension is common during spinal anesthesia and contributes to organ hypoperfusion. Inferior vena cava ultrasonography (IVC USG) has been used in critically ill patients for predicting volume responsiveness but data regarding its use in perioperative setting is limited. This study aims to evaluate the use of IVC USG to guide fluid management for prevention of hypotension after spinal anesthesia.

MATERIALS AND

METHODS

In this prospective, randomized, interventional study, 92 patients undergoing surgery under spinal anesthesia were randomized into USG group or Control group. In the USG group, IVC USG assessment and fluid management was performed before spinal anesthesia. In the control group, spinal anesthesia was performed without IVC USG assessment. In both the groups, incidence of hypotension and amount of fluid and vasopressors administered were recorded.

RESULTS

The incidence of hypotension was significantly lower in the USG group 14 patients (30%) when compared to the control group 24 patients (52%; P = 0.034). In both the groups, the median vasopressors requirements were not statistically significant (P = 0.116). The median amount of fluid administered in USG group was 460 ml while it was 300 ml in control group which was not statistically significant (P = 0.185). However, the median of amount of fluid administered after spinal anesthesia was 150 ml in the USG group as compared to 300 ml in the control group, which was statistically significant (P < 0.001).

CONCLUSION

IVC USG is an effective modality for optimization of volume status for prevention of hypotension after spinal anesthesia.