Comparison of Inferior Vena Cava Collapsibility Index by Point of Care USG (POCUS) and Standard Haemodynamic Monitoring as a Guide to Fluid Management in Post Spinal Hypotension - A Randomised Controlled Study

Spinal anaesthesia is one of the most commonly used methods of anaesthesia for infra umbilical procedures. . While it has advantages such as a rapid onset of action and being relatively cost effective, the most common and immediate complications are hypotension and bradycardia.

A reading of mean arterial pressure (MAP) less than 50 mmHg can be a significant cause of mortality and morbidity. Patients with inadequate volume reserve before the induction of anaesthesia are highly exposed. The identification of latent hypovolemia is therefore crucial. Inferior vena caval ultrasound (IVCUS) is effective to assess fluid responsiveness in critical care patients and has been proposed as a tool for assessing responsiveness in routine patients as well. The primary purpose of my study is to determine the efficacy of IVCCI in predicting this post spinal hypotension and managing the intra-operative fluid doses based on these values. The study will compare standard monitoring procedures i.e. Mean Arterial Pressure (MAP) with the IVCCI to determine which is more effective in predicting hypotension in these  patients. The study will assess the incidence of post spinal hypotension in the standard monitoring group (control) and USG guided measurement group (case) and compare the values obtained along with effectiveness of fluid therapy and fluid responsiveness in both groups.