The Predictive Value Of Inferior Vena Cava Collapse Index For Hypotension After Lumbar Anesthesia In Total Hip Arthroplasty

Objective:To analyze the predictive value of inferior vena cava collapse index（IVC-CI）for hypotension after lumbar anesthesia in patients undergoing total hip arthroplasty,and to explore whether preoperative hypertension would affect the predictive value of inferior vena cava collapse index（IVC-CI）for hypotension after lumbar anesthesia.Methods:choose 163 cases of in patients undergoing total hip replacement,lumbar hemp（SA）are given,according to whether preoperative hypertension,all patients were divided into combined hypertension group（group H）and the combined hypertension group（N group）,according to whether or not within 30 minutes after lumbar hemp appear low blood pressure can be divided into low blood pressure group（group D）and the hypotension group（group F）.The maximum diameter of vena cava（d IVC）and collapse index of inferior vena cava(d IVC_max)were measured by ultrasound before and after SA.Systolic blood pressure（SBP）,mean arterial pressure（MAP）and heart rate（HR）were recorded in all patients within 30 minutes before and after SA.Results:Hypotension occurred in 49 patients（30.06%）after lumbar anesthesia.Age,body mass index（BMI）,waist circumference,SBP,MAP,HR baseline value and incidence of hypotension after lumbar anesthesia in group H were significantly higher than those in group N（P<0.05）.The collapse index of inferior vena cava before and after SA in group D was significantly higher than that in group F（P<0.01）.The collapse index of inferior vena cava before and after SA in group N was inversely proportional to the lowest SBP and MAP within 30 min after SA（P<0.01）.The collapse index of inferior vena cava before and after SA in group H was inversely proportional to the lowest SBP and MAP within 30 min after SA（P<0.01）.The total area under ROC curve（AUC）of hypotension after lumbar anesthesia was significantly higher than d IVC_max before and after SA（P<0.01）.Conclusions:The collapse index of inferior vena cava before and after SA can predict and analyze the occurrence of hypotension after lumbar anesthesia in patients with and without hypertension after total hip arthroplasty,which can be used as a method to predict and analyze hypotension after lumbar anesthesia in patients with total hip arthroplasty.