ArticleCureus2025
Correlation Between Ultrasonographic Inferior Vena Cava Indices and Post-subarachnoid Anesthesia Hypotension: A Prospective Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionArterial hypotension is the most common adverse event following subarachnoid block (SAB). Numerous studies have attempted to predict its occurrence, but the results remain inconclusive. The use of 'preloading' with intravenous fluids as a preventive measure remains controversial. Ultrasonographic assessment of the inferior vena cava (IVC) may be useful for evaluating volemia; however, its role as a predictor of hypotension in SAB has not been thoroughly investigated.
objectiveTo describe the correlation between IVC parameters derived (IVC-PD), the collapsibility index (IVCCI), and the distensibility index (IVCDI), and the development of hypotension following SAB.
methodsThis was a prospective, analytical study of diagnostic technology involving 70 patients undergoing SAB. Baseline ultrasonographic measurements of IVC parameters were recorded. The evaluated IVC parameters included the end-expiratory diameter (IVCe > 2 cm), IVCCI (≥ 40%), and IVDI (≥ 18%). Hypotension was defined as systolic blood pressure (SBP) < 90 mmHg, mean arterial pressure (MAP) < 60 mmHg, or a decrease in SBP or MAP ≥ 25% in patients with arterial hypertension. Correlation strength was evaluated using Spearman's index (rho), and simple and binomial linear regression analyses were performed to assess other factors associated with hypotension.
resultsThe correlation between IVC parameters and post-SAB hypotension was weak and negative (rho = -0.058). Linear regression analysis did not yield statistically significant results ( DISCUSSION: The incidence of arterial hypotension was 27.14%, aligning with the upper range of previous studies. Risk factors such as a sensory block above T4 and a history of arterial hypertension were significantly associated with hypotension. However, no significant correlation was found between pre-anesthetic IVC-PD measurements and post-SAB hypotension, consistent with some prior findings. Variability across studies may relate to differences in patient characteristics and ventilation status.
conclusionWhile confirming established hypotension risk factors, this study did not support IVC-based prediction, contrasting with some literature. Further research should address limitations like sample size and single-center design to clarify IVC's role in spontaneously ventilating patients.
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