IS CAVAL AORTIC INDEX A GOOD TOOL FOR PREOPERATIVE VOLEMIA ASSESSMENT?

Introduction: Patient’s volemia assessment remains a challenge in anaesthetic management and is one of the causes of lack of control in Spinal Anesthesia Induced Hypotension (SAIH) prediction; however, Caval Aorta Index(IVC/Ao) measurement seems to be simple, fast and high-accuracy tool in evaluation of volemic status in elective orthopaedic surgery.Methods: Prospective, randomised study, performed on patients scheduled for elective anaesthesia in orthopaedic surgery; randomised into 2 groups: group 1 – patients with routine preloading with crystalloids; group 2 – patients with IVC/Ao evaluated ultrasonographically, and preloading at a Cut-off = 0.8. The outcome was appreciated by the incidence of hypotension after spinal anaesthesia in both groups. Results: BMI (p = 0.313) and age (p = 0.163) distribution by groups didn’t show a statistically significant difference in hypotension occurrence. Incidence of hypotension in both groups didn’t show significant statistical difference (p = 0.807).There was lack of association between hypotension occurrence and absence of preloading (Odds Ratio = 0.941, CI 95% 0.575 – 1.538).Conclusion: Caval Aorta Index represents a simple, fast, non-invasive, cost-effective method for volemia evaluation and it seems to be a good predictor of post-spinal anaesthesia hypotension.