Increase in airway pressure resulting from prone position patient placing may predict intraoperative surgical blood loss.

Abstract:

STUDY DESIGN:Prospective study on intraoperative blood loss during lumbar spine surgery. OBJECTIVE:To evaluate the relationship between airway pressure change due to the patient's prone position and intraoperative blood loss during lumbar spine surgery. SUMMARY OF BACKGROUND DATA:A prone position may increase abdominal pressure. Changes in abdominal pressure may influence airway pressure and cause intraoperative blood loss as a result of epidural venous congestion. METHODS:Patients undergoing lumbar spine surgery were placed in a prone position after the administration of general anesthesia. Peak airway pressure, plateau pressure, mean blood pressure, and heart rate were measured 5 minutes after anesthesia induction and 15 minutes after being placed in a prone position. Intraoperative blood loss was measured at the end of surgery. RESULTS:Mean peak airway pressure was 13.7 ± 1.8 mm Hg while in a supine position and increased to 15.1 ± 2.5 mm Hg after placement in the prone position (P = 0.002). Plateau pressure was 12.6 ± 2.5 mm Hg while in a supine position and increased to 14.1 ± 1.9 mm Hg after placement in a prone position (P = 0.0002). Intraoperative blood loss was correlated with peak (R2 = 0.405) and plateau (R2 = 0.489) airway pressure changes. CONCLUSION:Increase in airway pressure resulting from placement into a prone position may predict intraoperative surgical blood loss.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Koh JC,Lee JS,Han DW,Choi S,Chang CH

doi

10.1097/BRS.0b013e31828cb3e5

subject

Has Abstract

pub_date

2013-05-15 00:00:00

pages

E678-82

issue

11

eissn

0362-2436

issn

1528-1159

journal_volume

38

pub_type

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