Prospective Study of Trends in Peripheral Venous Pressures among Neurosurgical Patients during Intra Operative Period in a Tertiary Care Centre

Abstract

Background: Measurement of Central Venous Pressure (CVP) serves as an important hemodynamic monitor in major surgical procedures associated with blood loss and extensive fluid administration. In order to combat the risks associated with this highly invasive method, the peripheral venous pressure measurement as a trend monitor like central venous pressure measurement was introduced. Since the procedural complications and technical complications are less with peripheral venous pressure measurement it is emerging as a hemodynamic monitor in major neurosurgical procedures. Requirement of USS and highly qualified personnel not necessary for PVP measurement unlike central Venous Cannula insertion. Materials and Method: In this study 25 patients posted for major neurosurgical procedures, peripheral venous catheter was connected to a pressure transducer which was linked to multichannel monitor and the peripheral venous pressure trends are recorded every 15 minutes. AS CVP measurement is stipulated as standard hemodynamic measurement as per text books for neurosurgical procedures in parallel to PVP, CVP was also measured. Results: peripheral venous pressure recording serially done showed the trends in hemodynamics in various stages of surgery. Initial period of surgery showed lower, values trend due to induction and subsequent use of the mannital and diuretics. After correction of decreased trends in PVP gradual increase was showed in peripheral venous pressure. Peripheral venous pressure remained as higher value compared to the central venous pressure. Conclusion:Peripheral venous pressure can be used as a monitor for hemodynamic trends in major neurosurgical procedures and as a guide for intra operative fluid therapy. CVP can also be predicted from PVP. But PVP can't be used for aspiration of air embolism from heart clambers unlike central venous catheter.