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Hemodynamic effect of the prone position during anesthesia
Author(s) -
Yokoyama M.,
Ueda W.,
Hirakawa M.,
Yamamoto H.
Publication year - 1991
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1991.tb03382.x
Subject(s) - medicine , hemodynamics , anesthesia , inferior vena cava , prone position , cardiac output , cardiac index , cardiology
We studied 21 patients undergoing lumbar spinal surgery under halothane anesthesia on a convex saddle frame, in order to determine the hemodynamic effect of the prone position. A thermodilution pulmonary arterial catheter was placed in 14 patients (Group PA‐1: n = 8; and Group PA‐2: n = 6), and an inferior vena caval catheter in the remaining seven patients (Group IVC). Group PA‐1 and Group IVC patients were placed in the prone position on a convex saddle frame. In the prone position, the cardiac index (CI) decreased significantly from 3.1 ± 0.5 to 2.5 ± 0.3 (1·min ‐1 ·m ‐2 mean ± s.d., P <0.01) without accompanying significant changes in the other hemodynamic variables in Group PA‐1. The postural change in Group IVC did not exert a significant effect on the inferior vena caval pressure. Group PA‐2 were initially placed in the flat prone position on a flat saddle frame, which produced no significant changes in the hemodynamic variables. Then the convex curvature of the frame was adjusted to the grade appropriate for surgery, which produced a significant reduction in CI (from 2.9 ± 0.3 to 2.4 ± 0.4, P <0.05). We conclude that the prone position itself may not interfere with the circulatory function. The prone position using a convex saddle frame causes significant reductions in CI, but little change in the other hemodynamic variables.