Spinal-Induced Hypotension in Geriatric Patients

Tanta University

Status: Completed

Conditions: Geriatric Population; Spinal Induced Hypotension; Intravascular Volume

Treatments: Diagnostic Test: venous excess ultrasound score

Study type: Observational

Funder types: Other

Identifiers

NCT05862298

postspinal hypotension

Details and patient eligibility

About

The study will be conducted to asses preoperative condition of venous system by VExUS score and it's relation with the incidence of spinal induced hypotension in geriatric patients undergoing surgery with spinal anaesthesia.

Full description

An assessment of the intravascular volume deficit prior to the spinal anaesthesia conduction may help to predict the occurrence of a critical decrease in blood pressure, so several indices have been proposed to assess it's status depending on either a fluid challenge or an assessment of heart-lung interaction. Heart rate variability, passive leg raise test, and peripheral perfusion index have revealed good abilities to predict spinal induced hypotension. The inferior vena cava (IVC) collapsibility index provides high diagnostic accuracy in predicting spinal induced hypotension The VeXUS score is a four-staged validated protocol which evaluates the presence and severity of systemic venous congestion in the inferior vena cava (IVC) and organs (liver, gut, and kidneys) by evaluating the (IVC) diameter, venous waveforms of the hepatic vein (HV), portal vein (PV), and interlobar renal veins using colour Doppler (CD) and pulsed wave Doppler (PWD)

Enrollment: 120 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• . Patients aging 65 or older
• Lower body surgeries to be done with spinal anaesthesia
• BMI less than 30 kg/m2.
• Patients with ASA I-III

Exclusion criteria

• Patient refusal
• Major bloody surgeries (class c surgeries)
• Patients with a history of cardiovascular disorders including arrhythmias, heart failure, tricuspid or mitral regurgitation, dilated right atrium or ventricle, AF
• Patients with a history of respiratory disorders
• Patients with cirrhotic liver
• Patients with pulmonary hypertension
• Patients with renal diseases