Ultrasound Guided Preoperative Assessment of Inferior Vena Cava Collapsibility Index in Prediction of Intraoperative Hypotension in Patients Undergoing Laparoscopic Cholecystectomy Surgery under General Anesthesia

Abstract

Abstract Background Laparoscopic surgery aims to minimize trauma of the interventional process but still achieve a satisfactory therapeutic results. It is commonly performed because of various advantages such as reduced postoperative pain, faster recovery and more rapid return to normal activities, shorter hospital stay, and reduced postoperative pulmonary complications. Aim of the Work In this study we aim to evaluate effectiveness of preoperative IVC ultrasonography (IVC CI) in prediction of hypotension (mean arterial pressure >60 mmHg) which develops following intraabdomenal gas insufflation, and in determining hypovolemia occurring in patients undergoing laparoscopic cholecystectomy surgery under general anesthesia. Patients and Methods This study was a prospective observational study conducted on 50 patients inside the operative theatre of El demerdash hospital after ethical committee approval. Results There was a statistically significant negative correlation between IVC CI and Change of MBP (mmHg) After induction from baseline with; while Change of MBP (mmHg) After insufflation of abdomen from baseline was of negative correlation but insignificant as there was no dehydrated patients among this study group preoperatively according to our measurements and for ethical purposes we considered that if there was any patient needed hydration preoperative according to preoperative assessment of IVC-CI should be managed before surgery in order not to have intraoperative hypotension which can affect his wellness intra and postoperative, also all the patients were ASA I/II with no critical illness affect volemic status and usage of deprevan, fentanyl and atracurium during induction which can cause hypotension post induction. Conclusion In this study there was a statistically significant negative correlation between IVC CI and Change of MBP (mmHg) After induction from baseline; while Change of MBP (mmHg) After insufflation of abdomen from baseline is of negative correlation but insignificant. We believe that IVC ultrasonography may be helpful in prediction of preoperative hypovolemia in patients who underwent laparoscopic cholecystectomy.