Hemodynamics in Different Types of Anesthesia Depending on the Initial Blood Circulation Regime during Spine Surgery in Prone Position

Лизогуб, Микола Віталійович; Lyzohub, Mykola

doi:10.26693/jmbs04.05.149

Cited by 1 publication

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References 8 publications

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“…Recently, a method was found for predicting a high probability of developing circulatory instability in SA in the prone position by calculating the predictive index of hemodynamic instability (PIHI). If its level exceeds 0.5, the probability of hemodynamic destabilization during SA in the pront position is very high [6,7]. Iatrogenic correction in this case should consist in artificial filling of the vascular bed (infusion), if this measure is ineffectivein an artificial increase in vascular tone with α1-adrenomimetics.…”

Section: Rs Globalmentioning

confidence: 99%

“…The course of SA in the prone position has been studied in 65 patients operated for degenerative diseases of the spine. On the eve of the operation, in all patients PIHI has been calculated using the method developed By N. Lizogub and co-authors [6,7]. All patients have been undergone the same surgical intervention (transpedicular stabilization of 1-2 segments) under SA, performed using the same method, which consisted of the following.…”

Section: Rs Globalmentioning

confidence: 99%

“…Under the influence of SA, there is a decrease in SPVR, the increased level of which is compensatory without anesthesia. With insufficient myocardial reserves, arterial hypotension and a decrease in CI develop, which forces to compensate for the decrease in SPVR with the help of α1-adrenomimetics [7].…”

Section: Rs Globalmentioning

confidence: 99%

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Influence of Subarachnoid Anesthesia in the Prone Position on the Energy of Circulation

Georgijovych

Viktorivna

Kudinova

et al. 2020

RS Global - World Science

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The energy supply of the body has an energy price, which is paid, in particular, by the myocardium. This price depends on the circulatory conditions, which can also be affected by iatrogenic factors, such as subarachnoid anesthesia (SA) in the prone position. Decreasing of a vascular tone under the influence of SA requires the myocardium to increase energy consumption to maintain an adequate cardiac index (CI). With a resistive type of circulation, autoregulation of blood circulation may become untenable, that requires artificial maintenance of vascular tone with the α1-adrenomimetics, that also contribute to an increase in energy expenditure by the myocardium. All this makes the assessment of blood flow energy relevant.The aim of the study was to study the effect of SA in the prone position on the energy of circulation.65 patients underwent transpedicular stabilization of 1-2 segments under SA in the prone position have been examined. On the eve of the operation, the prognostic index of hemodynamic instability (PIHI) has been determined by the N. Lysohub’s method. At three stages (the position on the back after performing SA, 5 and 20 minutes after turning on the prone position), kinetic (systolic index, ejection fraction, heart rate and SI), dynamic (effective, or average, AP — APe, central venous pressure, the difference between them — systemic perfusion pressure and specific peripheral vascular resistance) and hemic (blood oxygen content) indicators have been determined. Based on these indicators and the energy potential of oxygen (the energy obtained by glucose oxidation by 1 mol of oxygen), the following energy parameters have been calculated: flow power index (FPI), tissue power consumption index (TPCI), oxygen reserve (OR) and circulatory reserve index (CRI). APe was maintained at least 60 mm Hg during anesthesia by infusion and, if necessary, by administration of the α1- adrenomimetic phenylephrine. Patients have been retrospectively divided into 2 groups: patients of the VF1 group (n = 25) needed phenylephrine administration, and patients of the VF2 group (n = 40) did not need it.The following results have been obtained. The minimum PIHI in the VF1 group was 0.1, which made it possible to expect a high probability of hemodynamic instability, while in the VF2 group it was no higher than 0.05. The integral kinetic parameter CI in the groups did not differ significantly, but the energy consumption and their efficiency between the groups significantly differed. FPI in the VF1 group was significantly lower than in the VF2 group, although TPCI did not differ significantly between the groups. TPCI compliance with tissue needs was determined by OR, which was significantly lower in the VF1 group. The final parameter CRI was significantly lower in the VF1 group, although CI did not differ significantly from the VF2 group level. This indicates energy insufficiency of circulation in patients with a resistive type of circulation against the background of SA in the prone position, so with this type, the presence of which is confirmed by a high PIHI, preference should be given to another type of anesthesia.

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Section: Rs Globalmentioning

confidence: 99%

Section: Rs Globalmentioning

confidence: 99%