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Haemodynamic effects of the prone position: a comparison of propofol total intravenous and inhalation anaesthesia
Author(s) -
Sudheer P. S.,
Logan S. W.,
Ateleanu B.,
Hall J. E.
Publication year - 2006
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2005.04464.x
Subject(s) - propofol , medicine , anesthesia , isoflurane , supine position , hemodynamics , cardiac index , cardiac output , heart rate , blood pressure , prone position
Summary The haemodynamic changes of the prone position were investigated in 40 ASA I–II patients undergoing lumbar spine surgery. Patients were randomly assigned, following propofol intravenous induction, to receive maintenance of anaesthesia using either isoflurane 1–1.2% in air or target controlled propofol 3 μg.ml −1 infusion. Measurements of non‐invasive blood pressure, heart rate and cardiac output were made in the supine position. The patient was then turned prone onto a Montreal pattern mattress and measurements repeated. Cardiac output measurements were made using a non‐invasive cardiac output monitor. We found a significant reduction in cardiac index in both groups and a significantly greater change with propofol compared to isoflurane on turning supine to prone (CI change 0.4 vs 0.7 l.min −1 .m −2 p = 0.001 and SVRI change 89 vs 177 dyne.s −1 .cm −5 , p = 0.041). We conclude that turning healthy patients prone produces a clinically significant reduction in cardiac output, the change being greater during maintenance of anaesthesia using propofol compared to isoflurane.