Comparing The Common Femoral Vein Diameter and The Inferior Vena Cava Diameter as A Predictor of Post-Induction Hypotension in Non-Cardiac Patients Undergoing General Anesthesia

Zaki, Mohamed Hani Kamal; Niazi, Alaa Abd El-Aziz Mahmoud; Hammad, Yahya Mohamed Ahmed; Elsharnouby, Ahmed Omar

doi:10.21608/ejhm.2023.291009

Comparing The Common Femoral Vein Diameter and The Inferior Vena Cava Diameter as A Predictor of Post-Induction Hypotension in Non-Cardiac Patients Undergoing General Anesthesia

Document Type : Original Article

Authors

Department of anesthesiology, Misr university for science and technology

10.21608/ejhm.2023.291009

Abstract

Background: Maintaining the stability of hemodynamics is crucial for the reduction of the rate of postoperative complications. Hypotension during surgery has profound effect on the heart, which may lead to myocardial injury, and hypoperfusion of the kidneys. Therefore, predicting post-induction hypotension (PIH) is crucial to surgical patients.
Objective: This study aimed to validate common femoral vein (CFV) diameter as a predictor for post-induction hypotension as compared to inferior vena cava (IVC) diameter.
Patients and Methods: 90 non-cardiac patients undergoing surgery under general anesthesia were recruited for the study. The diameters of (IVC) and CFV were measured by ultrasonography prior to the surgery and post induction. Blood pressure was monitored at predetermined points of time: before anesthesia, at zero time, and at 2 min intervals after that.
Results: In the current study, our results were consistent with the previously reported literature. The CFV diameter showed significant increase post induction compared to pre-induction. Such increase was concomitant with significant PIH in susceptible patients. Moreover, the changes observed in CFV diameter were synchronous with increase in IVC diameter in patients suffering from PIH. No significant changes were observed between age groups in either the IVC or CFV diameter. According to our observations, hypertensive patients suffered more PIH but the results were only significant regarding diastolic blood pressure.
Conclusion: Our results showed comparable predictability of CFV diameter to IVC diameter ultrasonographic measurements in anticipating post-induction hypotension (PIH) in generally anesthetized patients. Therefore, the CFV offers a reliable alternative in cases where the IVC cannot be visualized or had limited accuracy. Variations in CFV and IVC diameters were insignificant in different age categories, which indicate the reliability of both vessels regardless of age group.

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