Pressure-controlled ventilation could decrease intraoperative blood loss and improve airway pressure measures during...

Area of Science:

• Anesthesiology
• Surgical Procedures
• Cardiopulmonary Physiology

Background:

• Prone positioning during surgery can alter hemodynamic and airway pressure parameters.
• These alterations may significantly impact intraoperative blood loss.
• Ventilation modes, such as pressure-controlled ventilation (PCV), may influence these changes.

Purpose of the Study:

• To investigate the relationship between ventilation mode (PCV vs. volume-controlled ventilation [VCV]) and hemodynamic, airway pressure, and blood loss during prone lumbar discectomy.
• To assess how PCV affects intraoperative blood loss and physiological parameters compared to VCV in the prone position.

Main Methods:

• Patients undergoing lumbar discectomy in the prone position were allocated to either VCV or PCV.
• Tidal volume was maintained between 8-10 ml/Kg for VCV, while PCV adjusted peak inspiratory pressure to achieve the same tidal volume.
• Hemodynamic and respiratory parameters were recorded in supine and prone positions.

Main Results:

• Intraoperative blood loss and central venous pressure (CVP) were significantly lower with PCV compared to VCV.
• Heart rate and blood pressure decreased in the prone position, with minimal influence from the ventilation mode.
• PCV resulted in significantly lower peak airway pressures in both supine and prone positions compared to VCV.

Conclusions:

• PCV is associated with reduced intraoperative blood loss and central venous pressure during prone lumbar discectomy.
• PCV can mitigate adverse hemodynamic and airway pressure changes associated with prone positioning.
• PCV offers an advantage over VCV in managing airway pressures and reducing blood loss in this surgical context.