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首页> 外文期刊>BMC Anesthesiology >Lithotomy versus jack-knife position on haemodynamic parameters assessed by impedance cardiography during anorectal surgery under low dose spinal anaesthesia: a randomized controlled trial
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Lithotomy versus jack-knife position on haemodynamic parameters assessed by impedance cardiography during anorectal surgery under low dose spinal anaesthesia: a randomized controlled trial

机译：低剂量脊髓麻醉在肛门直肠手术期间通过阻抗心动描记术评估血液动力学参数的取石术对千斤顶刀位置：一项随机对照试验

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Background Although the prone position providing better exposure for anorectal surgery is required it can cause a reduction of cardiac output and cardiac index. The goal was to compare haemodynamic changes assessed by impedance cardiography during anorectal surgery under low-dose spinal anaesthesia in lithotomy and jack-knife position. Methods The prospective randomized controlled study included 104, ASA I-II adult patients admitted for elective minor anorectal surgery, assigned to be performed in lithotomy (groupL, n?=?52) or jack-knife position (groupJ, n?=?52). After arrival to operating room the standard monitoring, impedance cardiography device was connected to the patient, and the following variables were recorded: cardiac output, cardiac index, systemic vascular resistance, stroke index at times of arrival to operating room, placement for, start and end of surgery and placement to bed. Spinal block was made in the sitting position with 4?mg of 0.5% hyperbaric bupivacaine and 10?μg of Fentanyl injected over 2?min. Comparison was based on haemodynamic changes between and inside groups over time. Student’s t, chi square tests were used for statistical analysis with p? Results The reduction of cardiac output was statistically significant after placement of the patient into the prone position: from baseline 7.4+/?1.6 to 4.9+/?1.2 after placement for and 4.7+/?1.2 at the start and end of surgery (mean +/?SD l/min). The difference of cardiac output between groups was 2.0?l/min after positioning for and the start of surgery and 1.5?l/min at the end of surgery (p?2) in groupJ and between groups: by 1.0?l/min/m2 after placement for, 1.1 at the start and 0.8 at the end of surgery (p??5, p? Conclusions According to impedance cardiography, jack-knife position after low-dose spinal anaesthesia produces transitory, but statistically significant reduction of cardiac output and cardiac index with increase of systemic vascular resistance, compared to insignificant changes in lithotomy position. Trial registration Clinical Trials NCT02115178 webcite .
机译：背景技术尽管需要俯卧位为肛门直肠手术提供更好的暴露，但它可能导致心输出量和心脏指数降低。目的是比较在小剂量脊髓麻醉下截石术和千斤顶刀位置在肛门直肠手术期间通过阻抗心动图评估的血液动力学变化。方法前瞻性随机对照研究包括104例接受择期小肛肠手术的ASA I-II型成年患者，他们被分配为截石术（L组，n≥52）或J型刀位（J组，n≥52）。 ）。到达手术室后，将标准监护仪，阻抗心动图设备连接到患者，并记录以下变量：心输出量，心脏指数，全身血管阻力，到达手术室时的卒中指数，放置位置，开始时间和手术结束并放置在床上。在2分钟内注射4毫克0.5％的高压布比卡因和10毫克微克芬太尼，使坐位的脊柱发生阻塞。比较基于组之间和组内部随着时间的血流动力学变化。学生的t，卡方检验用于p的统计分析。结果将患者放置于俯卧位后心输出量的减少具有统计学意义：从放置后的基线7.4 + /？1.6到放置后的4.9 + /？1.2，以及手术开始和结束时的4.7 + /？1.2（平均值+ /？SD l / min）。 J组和各组之间，在定位和手术开始后，心输出量的差异为2.0？l / min，在手术结束时（p？2 ），心输出量的差异为1.5？l / min：1.0？ l / min / m 2 放置后，在手术开始时为1.1，在手术结束时为0.8（p ?? 5 ，p？）结论根据阻抗心动图，千刀位置小剂量脊髓麻醉后产生短暂的，但统计学上显着降低的心输出量和心脏指数，但与全身血管阻力的增加相比，切石术位置的变化不显着。临床注册临床试验NCT02115178网站。

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