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Inferior vena cava ultrasonography (IVC USG) may predict volume responsiveness, yet perioperative evidence remains limited. This prospective randomized interventional study evaluated IVC USG–guided fluid management to prevent post–spinal anesthesia hypotension in 92 surgical patients. The USG group showed a lower hypotension incidence and reduced post-anesthesia fluid requirements, while vasopressor and total fluid differences were otherwise not statistically significant. IVC USG supports effective volume status optimization to reduce hypotension.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/inferior-vena-cava-ultrasound-to-guide-fluid-management-for-prevention-of-hypotension-after-spinal-anesthesia-in-a-tertiary-level-teaching-hospital/439891/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/inferior-vena-cava-ultrasound-to-guide-fluid-management-for-prevention-of-hypotension-after-spinal-anesthesia-in-a-tertiary-level-teaching-hospital/439891.png","ImageObject",300,407,{"name":92,"@type":93},"Mabel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the study’s main goal?","Question",{"text":113,"@type":114},"To evaluate whether inferior vena cava ultrasonography (IVC USG) can guide fluid management to prevent hypotension after spinal anesthesia.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were patients assigned to the study groups?",{"text":118,"@type":114},"Ninety-two patients were randomized to an IVC USG group, where assessment and fluid management occurred before spinal anesthesia, or a control group, where spinal anesthesia was performed without IVC USG assessment.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the key outcome results?",{"text":122,"@type":114},"Hypotension occurred less often in the IVC USG group (30%) than in the control group (52%). Post–spinal anesthesia median fluid was lower in the IVC USG group (150 ml vs 300 ml), with statistical significance.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},439891,1791075562,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},7971474920318,"https://ap-avatar.wpscdn.com/avatar/74000ee537e6b0ca360?x-image-process=image/resize,m_fixed,w_180,h_180&k=1788430171632181674","Randomised Controlled Trial  \nInferior vena cava ultrasound to guide fluid management for prevention of hypotension after spinal anesthesia in a tertiary level teaching hospital  \nSemanta Dahal, MDa , Bishwas Pradhan, MDb , Amit S. Bhattarai, MDc , Shiva P. Paudyal, MDb , Anil Shrestha, MDc , Gentle S. Shrestha, MDd ,*  \nBackground: Hypotension is common during spinal anesthesia and contributes to organ hypoperfusion. Inferior vena cava ultrasonography (IVC USG) has been used in critically ill patients for predicting volume responsiveness but data regarding its use in perioperative setting is limited. This study aims to evaluate the use of IVC USG to guide fluid management for prevention of hypotension after spinal anesthesia.  \nMaterials and methods: In this prospective, randomized, interventional study, 92 patients undergoing surgery under spinal anesthesia were randomized into USG group or Control group. In the USG group, IVC USG assessment and fluid management was performed before spinal anesthesia. In the control group, spinal anesthesia was performed without IVC USG assessment. In both the groups, incidence of hypotension and amount of fluid and vasopressors administered were recorded.  \nResults: The incidence of hypotension was significantly lower in the USG group 14 patients (30%) when compared to the control group 24 patients (52%; P = 0.034) . In both the groups, the median vasopressors requirements were not statistically significant (P = 0. 116) . The median amount of fluid administered in USG group was 460 ml while it was 300 ml in control group which was not statistically significant (P = 0. 185) . However, the median of amount of fluid administered after spinal anesthesia was 150 ml in the USG group as compared to 300 ml in the control group, which was statistically significant (P \u003C 0.001) .  \nConclusion: IVC USG is an effective modality for optimization of volume status for prevention of hypotension after spinal anesthesia.  \nKeywords: collapsibility index, hypotension, inferior vena cava, spinal anesthesia, transthoracic echocardiography, ultrasound  \nIntroduction  \nHypotension is a frequently observed side effect of spinal anesthesia[1,2] . It is attributed to reduction in both cardiac output and systemic vascular resistance due to local anesthetic induced sympathetic blockade [3 ,4] . Even short duration of intraoperative mean arterial pressure (MAP) less than  \naDepartment of Critical Care Medicine, Om Hospital and Research Centre,  \nChabahil, Kathmandu, Nepal, bDepartment of Anesthesiology, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu, Nepal, cDepartment of Anesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal and dDepartment of Critical Care Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.  \n*Corresponding author. Address: Department of Critical Care Medicine, Tribhuvan University Teaching Hospital, GPO: 8975, EPC: 1785, Maharajgunj, Kathmandu, Nepal. Tel.: +[977 9841248584. E-mail: gentlesunder@hotmail.com](977 9841248584. E-mail: gentlesunder@hotmail.com)[ ](977 9841248584. E-mail: gentlesunder@hotmail.com)(G.S. Shrestha).  \nCopyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nAnnals of Medicine & Surgery (2026) 88:327–333  \nReceived 28 April 2025; Accepted 31 August 2025  \nSupplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal’s website, [www.lww.com/annals-of-medicine-and-surgery](www.lww.com/annals-of-medicine-and-surgery).  \nPublished online 25 November 202","cbCaiujf9B0r93ni","https://ap.wps.com/l/cbCaiujf9B0r93ni","pdf",604157,"English","# Background\n# Materials and methods\n# Results\n# Conclusion\n# Introduction","[{\"question\":\"What is the study’s main goal?\",\"answer\":\"To evaluate whether inferior vena cava ultrasonography (IVC USG) can guide fluid management to prevent hypotension after spinal anesthesia.\"},{\"question\":\"How were patients assigned to the study groups?\",\"answer\":\"Ninety-two patients were randomized to an IVC USG group, where assessment and fluid management occurred before spinal anesthesia, or a control group, where spinal anesthesia was performed without IVC USG assessment.\"},{\"question\":\"What were the key outcome results?\",\"answer\":\"Hypotension occurred less often in the IVC USG group (30%) than in the control group (52%). Post–spinal anesthesia median fluid was lower in the IVC USG group (150 ml vs 300 ml), with statistical significance.\"}]","Inferior Vena Cava Ultrasound to Guide Fluid Management for Prevention of Hypotension After Spinal Anesthesia in a Tertiary Level Teaching Hospital | PDF",1790690483,18]