Effects of Sub Arachnoid Block on Diameter and Cardio Respiratory Variations of Internal Jugular Vein in Term Pregnant Females Undergoing Elective LSCS: A Prospective Observational Study

Abstract

Background: The present study was aimed to observe effects of sub arachnoid block on diameter and cardio-respiratory variations of internal jugular vein (IJV) in term pregnant females undergoing elective LSCS. Material & methods: In this prospective observational study, a total of 30 parturients, between age group 20-40 years, belonging to ASA class II undergoing elective LSCS under sub- arachnoid block were analyzed at various stages of surgery viz. at baseline, at achieving T5 sensory block level, at delivery of baby and at closure of skin incision respectively at Department of Anesthesiology, Dr. RPGMC, Kangra at Tanda, H.P from February 2019 to May 2020. Results: In our study, overall baseline anthropometric measurements were comparable in our study population. There was statistically significant difference between the diameters (mean medio-lateral, antero-posterior diameters, minimum diameter at inspiration and maximum diameter at expiration ), cross- sectional areas of right and left internal jugular vein at various stages of surgery (viz. at baseline, at T5 sensory block level, at delivery of baby and at closure of skin). Right internal jugular vein diameter was larger than left internal jugular vein. There was statistically significant difference between the collapsibility index at delivery of baby and at closure of skin with respect to baseline (p- value <0.001) while there was no statistically significant difference between collapsibility index when T5 sensory level block was achieved and at baseline. There was 27% incidence of hypotension in our study population. There was statistically significant association (p-value <0.001) between time to achieve T5 sensory level block & incidence of hypotension. Conclusion: We found that right sided IJV diameters and cross sectional areas were larger when compared with left sided IJV. Diameters and cross-sectional areas decreased when T5 sensory level block was achieved, and then increased during delivery of baby and from delivery of baby to closure of skin. Keywords: Sub Arachnoid Block, Cardio-Respiratory Variation , Internal Jugular Vein , Term Pregnant Females ,Elective LSCS