In this observational study, we will assess cFT by Carotid ultrasound and IVC collapsibility index for prediction of hypotension after induction of general anesthesia in geriatric patients undergoing elective surgery.
American Society of Anaesthesiologists Physical Status I to Ⅱ
receiving general anesthesia for elective surgery
fasted for at least 6 to 8 hours were recruited in this study
• patients who refused to participate in the study
American Society of Anaesthesiologists Physical Status Ⅲ or Ⅳ
Patients with a history of peripheral arterial diseases or atherosclerosis
Patients with body mass index of greater than 30 kg/m2
geriatric patients (65 years and above) (10) of either sex and ASA PS I to Ⅱ receiving general anesthesia for elective surgery, who fasted for at least 6 to 8 hours were recruited in this study
Case-only
Prospective
Carotid Artery Corrected Flow Time measurement
Diagnostic test* The cFT is defined as the time between the onset of systolic flow until closure of the aortic valve corrected for the HR and has been found to correlate with the intravascular volume. * carotid ultrasound imaging will be performed 10 minutes before induction of general anesthesia in the preoperative holding area. * Ultrasound measurements will be performed under a vascular setting with a 6.0 to 13.0MHz linear array transducer * The right common carotid artery cFT will be measured in supine position with their heads tilted 30° to the left * After that, a pulse wave Doppler will be chosen, and the sampling frame will be positioned at an angle of less than 60° in the region of the carotid artery with the best color flow to acquire the blood flow spectrum.
Inferior vena cava collapsibility index
Diagnostic test* The IVC will be examined while the patient has been spontaneously, quietly breathing and lying in the supine position for at least 5 min before assessment. * A two-dimensional image of the IVC as it entered the right atrium will be obtained through the paramedian long-axis view via a subcostal approach using a curvilinear phased array probe (2-5 MHz) * Then, using M-mode imaging produced at a medium sweep speed, changes in IVC diameter with breathing will be evaluated 2 to 3 cm distal to the right atrium. * During the same respiratory cycle, measurements will be made of the IVC's greatest expiratory diameter (dIVC expiration) and lowest inspiratory diameter (dIVC inspiration). The formula IVCCI = (dIVC expiration - dIVC inspiration) × 100/dIVC expiration will be used to determine IVCCI as a percentage. (12) * IVCCI will be assessed by the same trained anesthesiologist who was blinded to postin duction hemodynamic measurements.
the diagnostic efficacy of cFT by Carotid ultrasound and IVC collapsibility index in prediction of hypotension after induction of general anesthesia in geriatric patients
the diagnostic efficacy of cFT by Carotid ultrasound and IVC collapsibility index in prediction of hypotension after induction of general anesthesia in geriatric patients undergoing elective surgery.
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