The Effect Of The Pre-Evaluation Of Inferior Vena Cava Collapse Index On Hypotension In Elderly Patients With Painless Colonoscopy

Objective:Observing the effect of pre-evaluation of the inferior vena cava collapse index by ultrasound to improve the hypotension and recovery quality of elderly patients undergoing painless colonoscopy.Methods:sixty elderly patients in the outpatients who underwent painless colonoscopy with propofol intravenous anesthesia,36 males,24 females,65-80 years old,body mass index(BMI)18-25 kg/m2,ASAI-II grade,they were randomly divided into two group,30 cases in each: the ultrasound group: the preoperative examination of the inferior vena cava collapse index,IVC-CI,maintained at 30%-40% after fluid replacement,and the control group: routine preoperative evaluation.Ultrasound group underwent ultrasound measurement of inferior vena cava collapse index,maintained at 30%-40% after fluid replacement pretreatment,conventional intravenous bolus propofol combined with nalbuphine for induction,when bispectral index(BIS)index value At 50-60,colonoscopy is started.The control group completed the routine preoperative evaluation.The incidence of hypotension,ephedrine usage rate,and SBP,DBP,MAP,and colonoscopy were observed during the induction of anesthesia(T0),1 min(T1),5 min(T2),and 10 min(T3),Record anesthesia time(S0),colonoscopy time(S1),call blink time(S2),complete consciousness recovery time(S3)(discontinued to steward rating 4 points)and wake quality(Steward recovery score)and Adverse reactions such as nausea,vomiting,lethargy,and dizziness occur.Results:Compared with T0,the levels of SBP,DBP and MAP in T1 and T2 were significantly lower(P<0.05).The levels of SBP,DBP and MAP in T3 group were significantly lower(P<0.05).There was no significant difference in the changes of ultrasound group.The levels of SBP,DBP and MAP in the control group were significantly lower than those in the ultrasound group at T1 and T2(P<0.05).Compared with the control group,the incidence of hypotension in the ultrasound group was significantly reduced,and the use rate of ephedrine was significantly reduced.The control group called blink time(S2)and consciousness waking time(S3)were significantly higher than the ultrasound group,the anesthesia time and colonoscopy time were not statistically significant(P>0.05).The quality of recovery in the ultrasound group was significantly increased(P<0.05).In the control group,2 patients(6.7%)had nausea and vomiting,and 1 patient(3.3%)had vertigo,which was significantly less than the nausea and vomiting in the control group(86.7%).There were 6 cases(20%)with dizziness and 0 cases with postoperative sleepiness in the ultrasound group(P<0.05).Conclusion:Preoperative ultrasound evaluation of inferior vena cava collapse index in elderly patients with painless colonoscopy can reduce the incidence of hypotension during the painless colonoscopy and the use of ephedrine,improve the quality of recovery and less adverse reactions,improve Patient comfort,which is conducive to the recovery of elderly patients.