Point of Care Ultrasound and Fluids Co-loading for the Prevention of Spinal-induced Hypotension in Dehydrated Elderly Patients and Cardiac Diseases

What this Trial Is About

This research investigates the use of point of care ultrasound (POCUS) and fluid co-loading to prevent spinal-induced hypotension in elderly patients with cardiac diseases undergoing surgery for proximal femur fractures. It focuses on patients over 70 years old who have cardiac conditions that reduce cardiovascular reserve, increasing their risk of hemodynamic instability after spinal anesthesia. Researchers aim to understand if fluid co-loading immediately after spinal anesthesia can reduce episodes of low blood pressure in these dehydrated patients. Participants receive transthoracic echocardiography (TTE) before spinal anesthesia to assess heart function and the inferior vena cava (IVC) characteristics. After spinal anesthesia with ropivacaine, patients are given continuous intravenous infusion of Lactate Ringer's solution. Ultrasound-guided nerve blocks are used before anesthesia to manage pain. Blood pressure and heart function are monitored closely during and after surgery, with hypotension treated according to clinical judgment. Throughout the study, patients undergo detailed heart imaging and monitoring, including ECG, echocardiography scans, and blood pressure measurements. Researchers measure the number of hypotension events after spinal anesthesia, guided by echocardiography, and assess patients' recovery in the post-anesthesia care unit. The study tracks heart performance indices and fluid status, aiming to improve management of spinal-induced hypotension in this vulnerable group.

Point of Care Ultrasound and Co-loading in Patients With Spinal-induced Hypotension and Cardiac Diseases