A recent study published in Ophthalmology Glaucoma indicates that statin use may increase the risk of developing post-spinal anesthesia hypotension (PSAH) in adults, particularly those in their 60s with hyperlipidemia. This research was part of the All of Us (AoU) program, which analyzed data from 69 adult patients scheduled for elective surgery under spinal anesthesia.
Statins are commonly prescribed to lower low-density lipoprotein cholesterol (LDL-C) and reduce cardiovascular disease (CVD) risk. However, as patients age, they are more susceptible to both glaucoma and CVD.
Study Findings
The study involved measuring the inferior vena cava collapsibility index (IVCCl) and the caval aorta index (IVC:Ao index) using ultrasound in the pre-operative period. Among the 69 patients studied, 23 developed PSAH.
Key results include:
The IVC:Ao index showed better sensitivity (0.696) and specificity (0.717) in predicting PSAH compared to the IVCCl, which had a sensitivity of 0.522 and specificity of 0.630.
Patients with high LDL-C levels (at least 100 mg/dL) were more likely to experience PSAH (9.2% vs. 7.9%) and had less access to eye care providers (72.6% vs. 75.5%).
The study found that age and the IVC:Ao index significantly contributed to the risk of developing PSAH, while factors such as sex, ASA physical status, body mass index (BMI), and IVCCl did not show significant effects.
Conclusion
The researchers concluded that the IVC:Ao index is a more reliable predictor of PSAH than the IVCCl. They recommend using the IVC:Ao index to assess volume status and guide fluid administration during spinal anesthesia to prevent hypotension.
However, the study’s authors noted that their sample size was limited due to the COVID-19 pandemic, suggesting that further research with larger samples is needed to explore the role of various factors in PSAH development.