Correlation of preoperative inferior vena cava diameter and inferior vena cava collapsibility index with preoperative fasting status, patient demography and general anaesthesia associated hypotension: A prospective, observational study

BACKGROUND AND AIMS: A definitive cutoff of inferior venacava (IVC) diameter in expiration (dIVCmax) and inferior vena cava collapsibility index (IVCCI) for predicting general anaesthesia associated hypotension (GAAH) is not yet determined. Primary objective of this study was to determine the correlation of dIVCmax and IVCCI, with GAAH. Other objectives were to determine the correlation of these IVC parameters with preoperative fasting duration, temperature and humidity. The correlation of dIVCmax with patient demography was also studied. METHODS: A total of 110 adult patients undergoing elective surgery under general anaesthesia were included in the study. IVC ultrasonography was done in the preoperative room, 20 to 30 minutes before shifting the patient to the operating room. Hypotension at (hypo@) 2 minutes and 10 minutes after administering vecuronium was recorded. RESULTS: Hundred and seven patients were analysed. A significant positive correlation was present between patient height and dIVCmax (r = 0.25, P = 0.009). Area under receiver operating characteristics curve was 0.595 (95% confidence interval (CI) 0.485–0.705) and 0.568 (95% CI 0.458–0.679) for dIVCmax and IVCCI for predicting hypo@2 min, with a diagnostic accuracy of 54% and 53%, respectively. dIVCmax ≤1.14 cm had a sensitivity of 31% and specificity of 87% in predicting GAAH. IVCCI ≥63.3% could predict GAAH with 31% sensitivity and 84% specificity. No significant correlation was found between preoperative IVC parameters and preoperative fasting or environmental factors. CONCLUSION: Both dIVCmax and IVCCI have poor diagnostic accuracy, with good specificity and low sensitivity in predicting GAAH. A steady formula for calculating baseline IVC diameter adjusted for patient demography is needed.