Internal jugular vein collapsibility index versus common carotid artery peak systolic velocity variation for prediction of post-spinal hypotension: A prospective observational study

Abstract Background and Aims: Post-spinal anesthesia hypotension (PSAH) is associated with significant adverse outcomes, prompting extensive research into predictive markers. This study aimed to evaluate and compare the predictive value of the internal jugular vein collapsibility index (IJV-CI) and common carotid artery peak systolic velocity variation (CCA-PSV) in forecasting PSAH. Material and Methods: A prospective observational study was conducted on 53 ASA I, II, and III adult patients undergoing elective surgery under spinal anesthesia (SAB). IJV-CI and CCA-PSV were examined using ultrasonography in all patients. SAB was administered using a standard protocol. PSAH was defined as a reduction of systolic blood pressure (SBP) ≥20%. Our primary objective was to evaluate the predictive value of IJV-CI and CCA-PSV for PSAH. The secondary objective was to compare their diagnostic efficacy. Results: PSAH was found in 39.6% (21 out of 53) patients. The area under the ROC curve for IJV-CI was 0.769 (95% CI: 0.903–0.636, P = 0.001). IJV-CI > 21.58% predicted PSAH with 71.43% sensitivity, 84.38% specificity, and 79.25% accuracy. The area under the ROC curve for CCA-PSV was 0.760 (95% CI: 0.888–0.631, P = 0.002). CCA-PSV >12.16% predicted PSAH with 85.71% sensitivity, 56.25% specificity, and 67.92% accuracy. With the maximum % fall in SBP, IJV-CI had a significantly low-positive correlation ( r = 0.298, P = 0.030), and CCA-PSV had a significant moderate positive correlation ( r = 0.483, P = 0.0002). Conclusions: Both IJV-CI and CCA-PSV are reliable predictors of PSAH. In terms of accuracy, IJV-CI is a better predictor of hypotension post-spinal anesthesia as compared to CCA-PSV.