Cardiothoracic & vascular anesthesia
Left ventricular end-diastolic pressure response to spinal anaesthesia in euvolaemic vascular surgery patients
Authors' conclusion
This study in euvolaemic patients undergoing elective vascular surgery provides evidence that SA improved LVEDP.
Study context
- Population
- Euvolaemic adults undergoing elective vascular surgery with spinal anaesthesia (SA); fluid administration targeted using arterial waveform monitoring; significant valvular disease excluded88.7% males
- Participants
- 62 adults
- Exposure
- Before vs after single-injection, low-dose spinal anaesthesia
- Outcome
- LVEDP estimated by the E/e' ratio on echocardiography
Methodological detailsbefore-and-after (pre/post spinal anaesthesia), echocardiographic assessment
- Before-and-after (pre/post spinal anaesthesia)
- Echocardiographic assessment
Main finding
As reported in the abstract
LVEDP (E/e' ratio), total population, before vs after SA
- E/e' ratio significantly decreased (10.80 [4.21] vs. 9.55 [3.91])
- p = 0.019
Observational data: associations, not effects.
Further findings
End-diastolic volume (EDV), total population
- EDV significantly decreased (147.51 ± 41.36 vs 141.72 ± 40.13 ml)
- P = 0.044
End-systolic volume (ESV), total population
- ESV significantly decreased (69.50 [51.50] vs 65.00 [29.50] ml)
- P < 0.001
Diastolic function, elevated vs normal left ventricular end-diastolic pressures (LVEDP) (subgroup)
- A increased only in the elevated LVEDP group (- 6.58 ± 11.12 vs. 6.46 ± 16.10)
- P < 0.001
- E/A decreased only in the elevated LVEDP group (0.02 ± 0.21 vs. - 0.36 ± 0.90)
- P = 0.004
- Greater decrease in E/e' with elevated vs normal LVEDP (- 0.03 ± 2.39 vs. - 2.27 ± 2.92)
- P = 0.002
- Overall improvement in diastolic function in patients with elevated vs normal LVEDP
Original publication
Left ventricular end-diastolic pressure response to spinal anaesthesia in euvolaemic vascular surgery patients. J Clin Monit Comput. Published 21 September 2024. doi:10.
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