title: Effect of postural changes on inferior vena cava dimensions and its influence on haemodynamics during caesarean section under spinal anaesthesia.
abstract: The effect of postural changes on inferior vena cava (IVC) dimensions and its influence on intra-operative haemodynamics in term parturients can be studied using abdominal ultrasound by a subcostal approach. Thirty-two term parturients scheduled to undergo elective caesarean section under spinal anaesthesia were recruited in this observational study. End expiratory diameter and collapsibility index of IVC was measured preoperatively in 3 different positions - supine, recumbent with wedge and left lateral positions. End expiratory diameter was significantly high in recumbent (10.79) and left lateral (12.27) compared with supine (9.96) position (P < 0.0001). A greater fall in systolic blood pressure (>20%) was noted in patients with collapsibility index of more than 11.5 in recumbent with wedge position with a positive predictive value of 86%. IVC dimensions change significantly with change in position and collapsibility index in recumbent position can be a useful parameter for predicting hypotension during caesarean section under spinal anaesthesia.
authors.affiliation: a Department of Anaesthesiology & Critical Care , JIPMER , Puducherry , India.
authors.forename: P
authors.initials: P
authors.lastname: Kundra
authors.affiliation: a Department of Anaesthesiology & Critical Care , JIPMER , Puducherry , India.
authors.forename: G
authors.initials: G
authors.lastname: Arunsekar
authors.affiliation: a Department of Anaesthesiology & Critical Care , JIPMER , Puducherry , India.
authors.forename: A
authors.initials: A
authors.lastname: Vasudevan
authors.affiliation: a Department of Anaesthesiology & Critical Care , JIPMER , Puducherry , India.
authors.forename: S
authors.initials: S
authors.lastname: Vinayagam
authors.affiliation: b Department of Obstetrics & Gynaecology JIPMER , Puducherry , India.
authors.forename: S
authors.initials: S
authors.lastname: Habeebullah
authors.affiliation: c Department of Radiodiagnosis , JIPMER , Puducherry , India.
authors.forename: A
authors.initials: A
authors.lastname: Ramesh
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal; D002585:Cesarean Section; D005260:Female; D006439:Hemodynamics; D006801:Humans; D056888:Patient Positioning; D011184:Postoperative Period; D011187:Posture / Q000502:physiology*; D011247:Pregnancy; D057234:Preoperative Period; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: caesarean; hypotension; inferior vena cava; spinal