SV and IVC Collapsibility Index to Predict Postinduction Hypotension

Postinduction hypotension (PIH) is associated with adverse postoperative outcomes. In this diagnostic accuracy observational study, adult patients aged 40-70 years with intestinal obstruction undergoing exploratory abdominal surgery under general anesthesia will be enrolled at Ain Shams University Hospitals. Prior to induction of general anesthesia, transthoracic echocardiography (TTE) will be performed to measure the stroke volume (SV) via LVOT-VTI and the inferior vena cava collapsibility index (IVC-CI). Patients will receive standard rapid sequence induction, and hemodynamic parameters will be monitored post-induction to evaluate the predictive value, sensitivity, and specificity of SV versus IVC-CI for postinduction hypotension. Secondary outcomes including incidence of PIH, length of hospital stay, PACU recovery time, and postoperative nausea and vomiting will also be recorded.

Inclusion criteria

• Adult patients with intestinal bowel obstruction undergoing exploratory abdominal surgery under general anesthesia.
• Age 40 to 70 years old.
• Body Mass Index (BMI) = 18 to 25 kg/m2.
• American Society of Anesthesiologists (ASA) physical status grade I or II.

Exclusion criteria

• American Society of Anesthesiologists (ASA) physical status grade >= III.
• Patients in whom the IVC cannot be visualized or patients with poor echogenicity.
• Patients with hemodynamic instability.
• Patients with vascular, respiratory, or cardiac diseases (e.g., cardiomyopathy, heart valve disease, arrhythmia, or bad exercise tolerance).
• Pregnant patients.
• Difficult airway or multiple intubatio