Sonographic assessment of internal jugular vein and carotid artery to correlate development of spinal hypotension in geriatric patients
DOI:
https://doi.org/10.31636/pmjua.v10i3-4.3Keywords:
internal jugular vein, carotid arteryAbstract
Introduction: Noninvasive and simple methods such as sonographic evaluation of the inferior vena cava (IVC), internal jugular vein (IJV)&carotid artery have gained popularity in recent years. Visualization of IVC is not feasible in some patients due to obesity, intra-abdominal gas distention, intra-abdominal mass or surgical dressings.In elderly patients, atherosclerosis of carotid artery influences blood flow and its evaluation is deemed necessary.
Methodology: After approval of ethics committee&after informed consent from patients,Prospective Observational study was conducted for 62 patients (patients>65 years) posted for elective surgeries under spinal Anaesthesia,at D.Y.Patil Hospital,Kolhapur.During spontaneous breathing,sonographic examination of Right IJV&Carotid artery were done with linear probe in M-mode. IJV Collapsibility Index (%) = [(max IJV diameter - min IJV diameter)/max IJV diameter] ×100 Using Standard anesthetic protocol, patient was given spinal anesthesia. Pulse, systolic, diastolic and mean blood pressure values were measured at 5-minute intervals for the first twenty minutes, and then every ten minutes up to one hour. Hypotension is defined as a decrease in the systolic blood pressure by 20% from baseline.
Results: Spinal Anaesthesia Induced Hypotension was shown in 44(70.97 %) of patients. IJV-CI increased significantly in Hypotensive group (mean+/–SD 37.30 +/–7.66) in comparison to Non-Hypotensive group (mean+/–SD 24.71+/–2.87) IJV-CI showed AUROC of 0.978 and 95 % C. I. of 0.950–1 (p value < 0.0001) with cut off value >18.29, 95.50 % sensitivity, 88.90 % specificity, 95.50 % PPV, 88.90 % NPV
Conclusion: Preanesthetic IJV-CI was predictor of Spinal Anaesthesia Induced Hypotension. Results suggested that IJV-CI > 18.29 to be the threshold levels, while CIMT could not predict Spinal Anaesthesia Induced Hypotension.
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Copyright (c) 2025 Ami Patel, Archita Patil, Sandeep Kadam, Rashmee Chavan
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