Effects of Spinal Anaesthesia on Left Ventricular Function: An Observational Study using Two-Dimensional Strain...

Area of Science:

• Cardiology
• Anesthesiology
• Echocardiography

Background:

• Hypotension is a common complication of spinal anaesthesia (SA), particularly in the elderly.
• This hypotension may involve impaired myocardial contractility.
• Two-dimensional (2D) strain imaging offers advanced assessment of myocardial function through deformation quantification.

Purpose of the Study:

• To evaluate the impact of SA on left ventricular function.
• To utilize 2D strain echocardiography for precise measurement of myocardial deformation.
• To investigate potential cardiac effects of SA in older patients.

Main Methods:

• Prospective observational study involving 20 patients over 60 years old undergoing elective lower-limb surgery under SA.
• 2D strain imaging was performed before and 20 minutes after SA administration.
• SA involved 10 mg isobaric bupivacaine with 5 μg sufentanil.

Main Results:

• A statistically significant increase in global longitudinal strain was observed post-SA (Δ-0.2±0.3% s^-1; p<0.005).
• Left ventricular ejection fraction remained unchanged following SA.
• Strain imaging detected subtle changes in myocardial function not apparent with standard echocardiography.

Conclusions:

• The observed increase in myocardial contractility may represent an adaptive mechanism.
• This adaptation could help compensate for reduced preload and mitigate blood pressure drops during SA.
• 2D strain echocardiography provides valuable insights into cardiac responses to SA in the elderly.