Postinduction hypotension (PIH) is a frequent complication during general anesthesia. This study aims to compare the predictive effectiveness and diagnostic accuracy of stroke volume (SV) measured via left ventricular outflow tract velocity time integral (LVOT-VTI) versus the inferior vena cava collapsibility index (IVC-CI) using transthoracic echocardiography. The assessment will be conducted in adult patients with intestinal obstruction undergoing exploratory abdominal surgery under general anesthesia.
Postinduction hypotension (PIH) is associated with adverse postoperative outcomes. In this diagnostic accuracy observational study, adult patients aged 40-70 years with intestinal obstruction undergoing exploratory abdominal surgery under general anesthesia will be enrolled at Ain Shams University Hospitals. Prior to induction of general anesthesia, transthoracic echocardiography (TTE) will be performed to measure the stroke volume (SV) via LVOT-VTI and the inferior vena cava collapsibility index (IVC-CI). Patients will receive standard rapid sequence induction, and hemodynamic parameters will be monitored post-induction to evaluate the predictive value, sensitivity, and specificity of SV versus IVC-CI for postinduction hypotension. Secondary outcomes including incidence of PIH, length of hospital stay, PACU recovery time, and postoperative nausea and vomiting will also be recorded.
Study Type
OBSERVATIONAL
Enrollment
75
Diagnostic accuracy of Stroke Volume (SV) to predict post-induction hypotension.
Area under the receiver operating characteristic curve (AUC) of stroke volume measured via left ventricular outflow tract velocity-time integral (LVOT-VTI) as a predictor of post-induction hypotension.
Time frame: Baseline (pre-induction) and immediately post-induction.
Diagnostic accuracy of Inferior Vena Cava Collapsibility Index (IVC-CI) to predict post-induction hypotension.
Area under the receiver operating characteristic curve (AUC) of inferior vena cava collapsibility index measured via transthoracic echocardiography (TTE) as a predictor of post-induction hypotension.
Time frame: Baseline (pre-induction) and immediately post-induction.
Incidence of Post-Induction Hypotension
Assessment of the proportion of patients who develop post-induction hypotension, defined as SBP decrease \> 30%, MAP decrease \> 20% from baseline, or absolute SBP \< 90 mmHg and MAP \< 60 mmHg.
Time frame: Within 3 minutes following induction of general anesthesia.
Length of Hospital Stay Length of Hospital Stay
Total duration of hospitalization from the day of surgery until discharge.
Time frame: From date of surgery until hospital discharge (up to 9 months).
Time to Recovery from Post-Anesthesia Care Unit (PACU) Time to Recovery from Post-Anesthesia Care Unit (PACU)
Time elapsed from patient admission to the PACU until meeting discharge criteria. Time elapsed from patient admission to the PACU until meeting discharge criteria.
Time frame: Intraoperative / immediate postoperative period until PACU discharge (up to 24 hours).
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