Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Original Investigation

Preoperative assessment of inferior vena cava collapsibility index by ultrasound is not a reliable predictor of post-spinal anesthesia hypotension

A avaliação pré-operatória do índice de colapsibilidade da veia cava inferior por ultrassonografia não é um preditor confiável de hipotensão pós-raquianestesia

Shayak Roy, Nikhil Kothari, Shilpa Goyal, Ankur Sharma, Rakesh Kumar, Narender Kaloria, Pradeep Bhatia

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Post-spinal anesthesia hypotension is of common occurrence, and it hampers tissue perfusion. Several preoperative factors determine patient susceptibility to hypotension. This study aimed to assess the effectiveness of the Inferior Vena Cava Collapsibility Index (IVCCI) for predicting intraoperative hypotension.

One hundred twenty-nine adult patients who were scheduled for elective surgical procedures after administration of spinal (intrathecal) anesthesia were included in the study. Ultrasound evaluation of the Inferior Vena Cava (IVC) was done in the preoperative area, and the patients were shifted to the Operating Room (OR) for spinal anesthesia. An independent observer recorded the change in blood pressure after spinal anesthesia inside the OR.

Twenty-five patients developed hypotension (19.37%). Baseline systolic blood pressure and mean blood pressures were statistically higher in those patients who developed hypotension (p = 0.001). The logistic regression analysis for IVCCI and the incidence of hypotension showed r2 of 0.025. Receiver Operating Characteristic (ROC) curve analysis demonstrated the Area Under the Curve (AUC) of 0.467 (95% Confidence Interval, 0.338 to 0.597; p = 0.615).

Preoperative evaluation of IVCCI is not a good predictor for the occurrence of hypotension after spinal anesthesia.


Hypotension;  IVCCI;  Spinal anaesthesia;  Ultrasound



A hipotensão pós-raquianestesia é comum e dificulta a perfusão tecidual. Vários fatores pré-operatórios determinam a suscetibilidade do paciente à hipotensão. Este estudo teve como objetivo avaliar a eficácia do Índice de Colapsibilidade da Veia Cava Inferior (ICVCI) para prever a hipotensão intraoperatória.


Cento e vinte e nove pacientes adultos agendados para procedimentos cirúrgicos eletivos após a administração de raquianestesia (intratecal) foram incluídos no estudo. A avaliação ultrassonográfica da veia cava inferior (VCI) foi realizada no pré-operatório e os pacientes foram encaminhados ao Centro Cirúrgico (CC) para raquianestesia. Um observador independente registrou a mudança na pressão arterial após raquianestesia dentro da sala de cirurgia.


Vinte e cinco pacientes desenvolveram hipotensão (19,37%). A pressão arterial sistólica basal e a pressão arterial média foram estatisticamente maiores nos pacientes que desenvolveram hipotensão (p = 0,001). A análise de regressão logística para ICVCI e incidência de hipotensão apresentou r2 de 0,025. A análise da curva Receiver Operating Characteristic (ROC) demonstrou a área sob a curva (AUC) de 0,467 (intervalo de confiança de 95%, 0,338 a 0,597; p = 0,615).


A avaliação pré-operatória de ICVCI não é um bom preditor para a ocorrência de hipotensão após raquianestesia.


Hipotensão; ICVCI; Anestesia espinhal; Ultrassom


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