• Yusuf Aslan, Gülten Arslan, Kemal Tolga Saraçoğlu, and Banu Eler Çevik.
• Department of Anesthesiology and Reanimation, University of Health Sciences, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey.
• Int. J. Clin. Pract. 2021 Oct 1; 75 (10): e14622.

AimsIn our study, we aimed to investigate whether end-expiratory vena cava inferior (expVCI) diameter and vena cava inferior collapsibility index predicted post-spinal hypotension in geriatric patients undergoing spinal anaesthesia (SA), the correlation between them and other parameters.Material And MethodsOur prospective study included the American Society of Anesthesiologists (ASA) I-4, 73 patients over 65 years of age, who were scheduled for operation using SA. According to the expVCI diameter displayed with ultrasonographic (USG) before SA, patients with an expVCI diameter less than 1.8 cm previously determined as the threshold value are grouped as 1 (small-VCI) group, those greater than 1.8 cm as 2 (large-VCI) group. Demographic characteristics of the patients, comorbidities, duration and type of operation, basal (preoperative) heart rate, systolic, diastolic, mean blood pressure, peripheral oxygen saturation values before SA and after SA in supine position (0 minute) and 5th, 10th, 15th, 20th, 25th, 30th min and preoperative arterial blood gas parameters, amount of preoperative urine and bleeding, inotropic and fluid requirement, complications were recorded.ResultsHypotension developed in 28 (38.4%) patients and bradycardia in 14(19.2%) of patients. The patients who developed hypotension had more ASA2 and ASA3 (P = .01), shorter height (P = .02) and smaller expVCI diameter (P = .004). It was observed that they had higher lactate (P = .03), lower pH (P = .006) values and more inotropic agents were administered (P < .001). While the rate of developing hypotension was 51.1% (n = 23) in the patients in the small-VCI group, this rate was 17.9% (n = 5) in the patients in the large-VCI group (P = .004).ConclusionIt was concluded that the expVCI diameter value measured by USG before SA in older adults is effective in predicting post-spinal hypotension with lactate and pH values, which are among the blood gas parameters, and expVCI can be preferred to invasive methods because of its noninvasive, easy and fast application.© 2021 John Wiley & Sons Ltd.

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