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Carotid Ultrasound for Post-Spinal Anesthesia Hypotension in Elderly Hip Surgery
Sponsor: Tanta University
Summary
This study aims to evaluate the predictability of preoperative carotid artery-corrected flow time (CFTc) for hypotension after spinal anesthesia in patients undergoing geriatric hip replacement surgery. Primary outcomes: • The predictive performance of preoperative CFTc for post-spinal hypotension . Secondary outcomes: * Cut-off value, sensitivity, specificity, positive predictive value and negative predictive value of CFTc in prediction of hypotension. * Cut-off value, sensitivity, specificity, positive predictive value and negative predictive value of IVC collapsibility. * Cut-off value, sensitivity, specificity, positive predictive value and negative predictive value of echocardiography (ECHO) (LVOT-VTI). * Comparison of predictive accuracy of CFTc, IVC, and ECHO for post-spinal hypotension. * Monitoring of systolic blood pressure (SBP), mean arterial pressure (MAP), and heart rate (HR) (first 10 min every 2 minutes, then at 15 min and at 20 min).
Official title: Predictability of Preoperative Carotid Artery-Corrected Flow Time for Hypotension After Spinal Anesthesia in Patients Undergoing Geriatric Hip Replacement Surgery: A Prospective Observational Study
Key Details
Gender
All
Age Range
65 Years - Any
Study Type
OBSERVATIONAL
Enrollment
50
Start Date
2026-10-15
Completion Date
2028-09-30
Last Updated
2026-10-15
Healthy Volunteers
No
Conditions
Interventions
Ultrasound
Preoperative point-of-care ultrasonography is performed using a diagnostic ultrasound system (SONY, General Electric (GE) Medical Systems) to evaluate baseline intravascular volume and hemodynamic status before spinal anesthesia. A high-frequency linear ultrasound probe is positioned over the common carotid artery proximal to its bifurcation to record pulsed-wave Doppler waveforms, measuring flow time from systolic upstroke to the dicrotic notch and calculating the corrected carotid flow time (CFTc) using Wodey's formula across three averaged cycles. The ultrasound device is additionally used with a 2-4 megahertz (MHz) transducer to measure the inferior vena cava collapsibility index (IVCCI) via subcostal M-mode imaging during an inspiratory sniff, as well as the left ventricular outflow tract velocity time integral (LVOT-VTI) via apical five-chamber echocardiography, to determine their accuracy in predicting post-spinal anesthesia hypotension.
Locations (1)
Faculty of Medicine, Tanta University
Tanta, Gharbia Governorate, Egypt