Abstract: Objective To investigate the predictive effect of ultrasound measurement of inferior vena cava
collapsibility index (IVC-CI) on postspinal anesthesia hypotension (PSAH) in elderly patients and whether preoperative
hypertension affects IVC-CI predictive value of PSAH. MethodsA total of 163 elderly patients undergoing elective
surgery under spinal anesthesia (SA) were enrolled in this study. According to the preoperative diagnosis of hypertension,
patients were divided into patients with hypertension group (H group) and patients without hypertension group (N group).
Then according to the occurrence of PSAH during 30 min after SA, the two group were subdivided into hypotension group (D
group) and non-hypotension group (F group). The maximum inferior vena cava diameters (dIVCmax) and IVC-CI were
measured before and after SA. The systolic blood pressure (SBP), mean arterial pressure (MAP), and heart rate (HR) were
recorded before SA and 30 min after SA. Results There were 49 patients (30.1%) had hypotension after SA. The baseline
values of age, body mass index (BMI), waist circumference, incidence of PSAH, SBP, MAP and HR were significantly higher
in group H than those in group N (P＜0.05). Before SA and after SA, dIVCmax was significantly smaller in group D than that of
group F (P＜0.05). Before SA and after SA, IVC-CI was significantly greater in group D than that of group F (P＜0.01).
Before SA and 30 min after SA, IVC-CI was negatively correlated with the lowest SBP and MAP in N group (P＜0.01). In H
group, before SA and 30 min after SA, IVC-CI was negatively correlated with the lowest SBP and MAP (P＜0.01). Before
and after SA, the area under ROC curve (AUC) of PSAH predicted by IVC-CI was significantly larger than that of dIVCmax
(P＜0.01). ConclusionBefore and after spinal anaethesia, IVC-CI can predict the occurrence of PSAH of the elderly
patients with hypertension, and which can be used as a noninvasive method for predicting PSAH in the elderly patients.

Key words: vena cava, inferior, hypotension, anesthesia, spinal, ROC curve, inferior vena caval collapsibility index,
elderly patients