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Hemodynamic effect of the prone position during anesthesia
M Yokoyama1, W Ueda, M Hirakawa
1Department of Anesthesiology and Orthopedic Surgery, Kochi Medical School, Japan.
Acta Anaesthesiologica Scandinavica
|November 1, 1991
Summary
The prone position on a convex saddle frame significantly reduces cardiac index (CI) during lumbar spinal surgery. However, this postural change has minimal impact on other hemodynamic variables, suggesting circulatory function is largely preserved.
Area of Science:
- Anesthesiology
- Cardiovascular Physiology
- Neurosurgery
Background:
- The prone position is common in spinal surgery.
- The hemodynamic effects of the prone position, particularly with specialized frames, require further elucidation.
Purpose of the Study:
- To investigate the hemodynamic effects of the prone position during lumbar spinal surgery.
- To assess the impact of a convex saddle frame on circulatory function.
Main Methods:
- Studied 21 patients undergoing lumbar spinal surgery under halothane anesthesia.
- Utilized thermodilution pulmonary arterial catheters and inferior vena caval catheters.
- Compared hemodynamic variables in different prone positions (flat vs. convex frame).
Main Results:
- The prone position on a convex saddle frame significantly reduced cardiac index (CI) (P < 0.01).
- No significant changes in other hemodynamic variables were observed in the convex frame group.
- A flat prone position showed no significant hemodynamic changes.
- Adjusting the convex frame curvature also led to a significant CI reduction (P < 0.05).
Conclusions:
- The prone position itself does not significantly interfere with overall circulatory function.
- The use of a convex saddle frame in the prone position significantly reduces CI but has minimal impact on other hemodynamic parameters.