Comparison of Inferior Vena Cava Collapsibility Index and Plethysmographic Variability Index for Predicting Hypotension after Induction of General Anesthesia

Background; Hypotension induced by general anesthesia induction is a frequent complication. This is due to vasodilation and suppression of cardiac function. Resulting in hypoperfusion of vital organs and consequent myocardial infarction, acute kidney injury, ischemic stroke & postoperative mortality. Aim and objectives; Assess the predictive capability of the preoperative plethysmographic variability index in relation to post-induction hypotension, in contrast to inferior vena cava (IVC) diameter as assessed by ultrasound. Subjects and methods; This prospective cohort research was carried out in Air Force Military Hospital after approval of Ethics Committee, AFCM (ID 10) & following the guidelines of STARD (Standards for Reporting Diagnostic accuracy studies). Written informed consent was obtained from all patients. Result; ​ MAP after induction was significantly lesser among cases who advanced hypotension compared to normotensive patients. IVCCI achieved significant at cutoff level > 40 in predicting hypotension after induction with specificity of 88.6%& sensitivity of 92%. Also, PI achieved significant at cutoff level > 2.48 in predicting hypotension after induction with specificity of 73.1% & sensitivity of 76.3%. Conclusion; IVCCI, achieved excellent predictive ability in adult cases having elective surgeries below general anesthesia with cutoff level > 40, sensitivity of 92% and specificity of 88.6%. Similarly, PVI showed a good predictive ability at cutoff level > 19.42 with sensitivity of 84% and specificity of 77.1%. Also, PI showed a good predictive ability at cutoff level > 2.48 with sensitivity of 76.3% and specificity of 73.1%.