Bloeddrukdaling na wisseling van supine naar prone positie bij spinale chirurgie.

Luiting, W.H. (Willem Henk) (2014) Bloeddrukdaling na wisseling van supine naar prone positie bij spinale chirurgie. thesis, Medicine.

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Abstract

Introduction: When patients are undergoing spinal surgery they need to be turned from supine position to prone position. After turning the patients to prone position hemodynamic changes occur and sometimes blood pressure decreases. It is unknown what the incidence and risk factors are and which hemodynamic changes occur. Material and method: This study was a prospective observational study. Patients undergoing spinal surgery with general anesthesia in prone position were included in this study. Before the operation the cardiac history, use of antihypertensive medication, demographic data, fasting time and operation position was registered. The CcNexfin® was applied before induction and measured the MAP, CI, SVRI, SVI en dP/dt per cardiac cycle, until 10 minutes after turning into prone position. During the operation the type of interventions and the time of use were registered. Results: During this study period 37 patients were included. Ten of the patient had a blood pressure decrease after turning into prone position. There was no significant difference in cardiac history, use of antihypertensive medication, demographic data, type of prone position or fasting time between the group with a decline in blood pressure and the group without a decline in blood pressure. The CI, SVI and dP/dt were significant lower after turning into prone position. The SVRI was not significant different between before and after turning into prone position and between the groups. Conclusion: It is difficult to draw conclusions due to the chosen study design. This study showed no risk factors for blood pressure decrease after turning into prone position. After turning into prone position the MAP, CI, SVI and dP/dt were significant lower. Patients with a decline in blood pressure tend to have worse heart function (low CI, SVI and dP/dt) before turning and a high SVRI, although this difference is not statistically significant. If a decrease in blood pressure occurs, inotropics or fluid supplementation seems to be a more logical choice than vasopressors.

Item Type:	Thesis (Thesis)
Supervisor name:	Absalom, Prof. Dr. A.R.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:58
Last Modified:	25 Jun 2020 10:58
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1867

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