Can Ultrasound-Guided Femoral Vein Measurements Predict Spinal Anesthesia-Induced Hypotension in Non-Obstetric Surgery? A Prospective Observational Study
Abstract
:1. Introduction
2. Material and Methods
2.1. Ethics and Study Design
2.2. Participants
2.3. Anesthesia-Related Features
2.3.1. Before Spinal Anesthesia
2.3.2. During and after Spinal Anesthesia
2.4. Sonographic Technique and Measurements
2.4.1. Inferior Vena Cava Measurements
2.4.2. Femoral Vein Measurements
2.5. SAIH Criteria and Treatment
2.6. Outcomes
2.7. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Hypotension | ||||
---|---|---|---|---|
All Patients | No (n = 83) | Yes (n = 12) | p | |
Age | 51 (19–71) | 48 (21–71) | 58 (19–70) | 0.081 |
Sex | ||||
Male | 62 (65.3%) | 53 (63.9%) | 9 (75.0%) | 0.533 |
Female | 33 (34.7%) | 30 (36.1%) | 3 (25.0%) | |
Body mass index (kg/m2) | 26.0 (16.5–39.0) | 26.1 (16.5–35.0) | 25.4 (19.0–39.0) | 0.494 |
ASA classification | ||||
1 | 51 (53.7%) | 50 (60.2%) | 1 (8.3%) | 0.002 |
2 | 44 (46.3%) | 33 (39.8%) | 11 (91.7%) | |
Department of surgery | ||||
Urology | 19 (20.0%) | 16 (19.3%) | 3 (25.0%) | 0.240 |
Orthopedics | 38 (40.0%) | 36 (43.4%) | 2 (16.7%) | |
Cardiovascular | 13 (13.7%) | 10 (12.0%) | 3 (25.0%) | |
General | 25 (26.3%) | 21 (25.3%) | 4 (33.3%) | |
Inferior vena cava | ||||
Maximum diameter (cm) | 2.45 (1.30–3.20) | 2.56 (1.30–3.20) | 2.05 (1.89–2.87) | 0.728 |
Minimum diameter (cm) | 2.01 (0.70–2.90) | 2.04 (0.70–2.90) | 1.96 (1.34–2.30) | 0.556 |
Collapsibility index (%) | 18.52 (1.99–58.58) | 18.29 (4.49–58.58) | 20.00 (1.99–31.98) | 0.556 |
Femoral vein | ||||
Maximum diameter (cm) | 0.93 (0.57–1.40) | 0.93 (0.59–1.40) | 0.95 (0.57–1.19) | 0.982 |
Minimum diameter (cm) | 0.78 (0.39–1.03) | 0.78 (0.42–1.03) | 0.83 (0.39–1.02) | 0.766 |
Collapsibility index (%) | 15.52 (1.32–40.71) | 16.05 (1.32–40.71) | 10.99 (4.41–34.45) | 0.370 |
Systolic blood pressure (mmHg) | |
Baseline | 146 (107–178) a |
0th minute | 142 (110–171) a |
1st minute | 131 (95–164) b |
5th minute | 124 (90–168) c |
10th minute | 118 (73–157) d |
15th minute | 118 (77–160) d |
p | <0.001 |
Diastolic blood pressure (mmHg) | |
Baseline | 82 (58–104) a |
0th minute | 75 (54–103) a |
1st minute | 70 (48–99) b |
5th minute | 67 (45–96) bc |
10th minute | 63 (42–92) d |
15th minute | 64 (51–98) cd |
p | <0.001 |
Mean blood pressure (mmHg) | |
Baseline | 103 (61–129) a |
0th minute | 101 (66–127) a |
1st minute | 94 (61–121) b |
5th minute | 89 (63–116) b |
10th minute | 81 (61–114) c |
15th minute | 82 (61–117) c |
p | <0.001 |
Heart rate (beats/min) | |
Baseline | 76 (58–118) a |
0th minute | 76 (51–117) a |
1st minute | 78 (55–114) a |
5th minute | 76 (53–113) ab |
10th minute | 76 (46–108) b |
15th minute | 73 (51–107) b |
p | <0.001 |
Hypotension criteria met | |
Decrease in systolic blood pressure, ≥30% | 12 (12.6%) |
Systolic blood pressure, <90 | 5 (5.3%) |
Mean blood pressure, <60 | 0 (0.0%) |
β Coefficient | Standard Error | p | Exp(β) | 95.0% CI for Exp(β) | ||
---|---|---|---|---|---|---|
Age | 0.051 | 0.032 | 0.114 | 1.052 | 0.988 | 1.121 |
Sex, Female | −0.839 | 0.808 | 0.299 | 0.432 | 0.089 | 2.105 |
Body mass index | −0.028 | 0.099 | 0.779 | 0.973 | 0.801 | 1.181 |
ASA classification, 2 | 2.707 | 1.102 | 0.014 | 14.982 | 1.727 | 129.930 |
Department, Orthopedics | −1.500 | 0.946 | 0.113 | 0.223 | 0.035 | 1.426 |
Inferior vena cava collapsibility index | −0.049 | 0.042 | 0.235 | 0.952 | 0.877 | 1.033 |
Femoral vein collapsibility index | −0.004 | 0.037 | 0.925 | 0.996 | 0.926 | 1.072 |
Constant | −4.092 | 3.270 | 0.211 | 0.017 |
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Yılmaz, A.; Demir, U.; Taşkın, Ö.; Soylu, V.G.; Doğanay, Z. Can Ultrasound-Guided Femoral Vein Measurements Predict Spinal Anesthesia-Induced Hypotension in Non-Obstetric Surgery? A Prospective Observational Study. Medicina 2022, 58, 1615. https://doi.org/10.3390/medicina58111615
Yılmaz A, Demir U, Taşkın Ö, Soylu VG, Doğanay Z. Can Ultrasound-Guided Femoral Vein Measurements Predict Spinal Anesthesia-Induced Hypotension in Non-Obstetric Surgery? A Prospective Observational Study. Medicina. 2022; 58(11):1615. https://doi.org/10.3390/medicina58111615
Chicago/Turabian StyleYılmaz, Ayşe, Ufuk Demir, Öztürk Taşkın, Veysel Garani Soylu, and Zahide Doğanay. 2022. "Can Ultrasound-Guided Femoral Vein Measurements Predict Spinal Anesthesia-Induced Hypotension in Non-Obstetric Surgery? A Prospective Observational Study" Medicina 58, no. 11: 1615. https://doi.org/10.3390/medicina58111615