Effect of Neuraxial Anaesthesia on Left Ventricular Diastolic Function Assessed by Transthoracic Echocardiography

Vol 2 | Issue 2 | July-December 2021 | Page 131-136 | Maithriye Kavishree, Srinath Damodaran, Sharanu Patil, Kumar Belani, Muralidhar Kanchi

DOI: 10.13107/ijra.2021.v02i02.041


Authors: Maithriye Kavishree [1], Srinath Damodaran [1], Sharanu Patil [2], Kumar Belani [3], Muralidhar Kanchi [1]

[1] Department of Cardiac Anaesthesia, Narayana Institute of Cardiac Sciences, Narayana Health City, Bangalore, Karnataka, India.
[2] Department of Anaesthesia and Intensive care, Sparsh Hospital, Bangalore, Karnataka, India.
[3] Department of Cardiac Anaesthesia, Masonic Children’s Hospital, University of Minnesota, Minneapolis, United States of America.

Address of Correspondence
Dr. Muralidhar Kanchi
Academic Director, Senior Consultant & Professor, Department of Cardiac Anaesthesia, Narayana Institute of Cardiac Sciences, Narayana Health City, Bangalore, Karnataka, India.
E-mail: muralidhar.kanchi.dr@narayanhealth.org


Abstract


Purpose: To evaluate the effect of neuraxial anaesthesia on left ventricular (LV) diastolic function in clinical setting using transthoracic echocardiography (TTE).
Methods: This prospective observational study was performed in 50 adult patients undergoing elective orthopaedic surgical procedures under neuraxial anaesthesia for lower limb surgery. TTE was performed before, 20, 40 and 60 minutes after neuraxial anaesthesia. Pulsed wave Doppler of the transmitral flow (TMF), pulmonary venous flow (PVF), deceleration time (DT) and propagation velocity (Vp) were measured. Septal and lateral wall mitral annular velocities (E’, A’) were assessed by tissue Doppler imaging (TDI). The maximum diameter of left atrium (LA) and right atrium (RA), LA volume index, left ventricular (LV) and right ventricular (RV) end-diastolic area (EDA), end-systolic area (ESA), fractional area change (FAC),LV end-diastolic volume (EDV), end-systolic volume (ESV), were measured from apical 4-chamber view (A4CV) view.
Results: There were 50 patients in the cohort of whom 48 had normal diastolic function preoperatively. Following neuraxial anaesthesia, mean arterial pressure decreased (96.61.52 to 83.70.3, p <0.001) while heart rate remained unchanged (84.416.6 to 85.315.0, p =0.436). The dimensions and volumes of cardiac chambers, LV FAC and RV FAC transmitral pulse wave Doppler, DT, Vp, PVF and mitral annular TDI did not vary after neuraxial anaesthesia (p>0.05).
Conclusion: In patients with normal diastolic function, neuraxial anaesthesia does not alter diastolic function indices and grading. “It is recommended that the study be performed in patients with documented diastolic dysfunction to demonstrate beneficial or detrimental effects of central neuraxial blockade, if any.”
Keywords: Spinal anaesthesia, Neuraxial anaesthesia, Transthoracic echocardiography, Diastolic function, Left ventricle


References


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How to Cite this Article: Kavishree M, Damodaran S, Patil S, Belani K, Kanchi M | Effect of Neuraxial Anaesthesia On Left Ventricular Diastolic Function Assessed By Transthoracic Echocardiography | July-December 2021; 2(2): 131-136.


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