• Georgia Gkounti, Charalampos Loutradis, Christos Katsioulis, Vasileios Nevras, Myrto Tzimou, Apostolos G Pitoulias, Helena Argiriadou, Georgios Efthimiadis, and Georgios A Pitoulias.
• Second Department of Surgery- Division of Vascular Surgery, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece. g-goudi@hotmail.com.
• J Clin Monit Comput. 2024 Sep 21.

PurposeRegional anaesthesia techniques provide highly effective alternative to general anaesthesia. Existing evidence on the effect of spinal anaesthesia (SA) on cardiac diastolic function is scarce. This study aimed to evaluate the effects of a single-injection, low-dose SA on left ventricular end-diastolic pressures (LVEDP) using echocardiography in euvolaemic patients undergoing elective vascular surgery.MethodsThis is a prospective study in adult patients undergoing elective vascular surgery with SA. Patients with contraindications for SA or significant valvular disease were excluded. During patients' evaluations fluid administration was targeted using arterial waveform monitoring. All patients underwent echocardiographic studies before and after SA for the assessment of indices reflective of diastolic function. LVEDP was evaluated using the E/e' ratio. Blood samples were drawn to measure troponin and brain natriuretic peptide (BNP) levels before and after SA.ResultsA total of 62 patients (88.7% males, 71.00 ± 9.42 years) were included in the analysis. In total population, end-diastolic volume (EDV, 147.51 ± 41.36 vs 141.72 ± 40.13 ml; p = 0.044), end-systolic volume (ESV, 69.50 [51.50] vs 65.00 [29.50] ml; p < 0.001) and E/e' ratio significantly decreased (10.80 [4.21] vs. 9.55 [3.91]; p = 0.019). In patients with elevated compared to those with normal LVEDP, an overall improvement in diastolic function was noted. The A increased (- 6.58 ± 11.12 vs. 6.46 ± 16.10; p < 0.001) and E/A decreased (0.02 ± 0.21 vs. - 0.36 ± 0.90; p = 0.004) only in the elevated LVEDP group. Patients with elevated LVEDP had a greater decrease in E/e' compared to those with normal LVEDP (- 0.03 ± 2.39 vs. - 2.27 ± 2.92; p = 0.002).ConclusionThis study in euvolaemic patients undergoing elective vascular surgery provides evidence that SA improved LVEDP.© 2024. The Author(s), under exclusive licence to Springer Nature B.V.

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