Investigation of The Factors Predicted For Hypotension Developing After Position Change in Patients Which Was Performed in The Prone Position

Selim Can Yırtımcı; Seyda Efsun Ozgunay; Mehmet Gamlı

Makale detayları

Investigation of The Factors Predicted For Hypotension Developing After Position Change in Patients Which Was Performed in The Prone Position

Yazarlar:

Selim Can Yırtımcı | Seyda Efsun Ozgunay | Mehmet Gamlı

Yayıncı:

Karyay Karadeniz Yayımcılık

Ana Başlıklar:

Cerrahi (Diğer)

Dergi:

Black Sea Journal of Health Science Vol.7 Issue 6, pp.240-247

Belge Tipi:

Makale

Yayın Tarihi:

11/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001331261

pISSN:

2619-9041

Anahtar kelimeler:

Özet:

 Hypotension may develop after returning from the supine position to the prone position in patients undergoing spine surgery. Intraoperative hypotension has been shown to be associated with serious complications. Our aim is to reveal the risk factors in the development of hypotension associated with position change in this patient group. 103 patients over the age of 18 who will undergo spinal surgery in the prone position under general anesthesia were included in our prospective, observational study. The detailed medical history of the patients and the drugs they used were recorded. PPV monitoring was applied to the patients who were taken to the operating room. After returning to the prone position, patients with MAP below 55 mmHg on arterial monitoring or with a blood pressure reduction of more than 20 percent according to preoperatively measured MAP were in the hypotensive group Group H, 50 patients, the remaining patients were in the normotensive group Group N, 53 patients were divided into two groups. Demographic data, comorbidity frequencies, antihypertensive used, perioperative PPV values, ejection fraction rates, lung compliance and airway pressure values were compared between the two groups. The rate of comorbidity, diagnosis of hypertension, beta-blocker drug class, and high pre-induction PPV value were found to be statistically significantly higher in Group H. In addition, the mean age was higher and the rate of smoking was lower in Group H. No significant difference was detected in other demographic data. Ejection-fraction ratio was found to be significantly lower in Group H. There was no difference between the two groups in terms of lung compliance, peak inspiratory pressure, plateau pressure, and lung driving pressure. High PPV value, diagnosis of hypertension, use of beta-blocker can be counted among the reasons for the development of hypotension after repositioning in patients undergoing vertebral surgery that will return to the prone position.

 Hypotension may develop after returning from the supine position to the prone position in patients undergoing spine surgery. Intraoperative hypotension has been shown to be associated with serious complications. Our aim is to reveal the risk factors in the development of hypotension associated with position change in this patient group. 103 patients over the age of 18 who will undergo spinal surgery in the prone position under general anesthesia were included in our prospective, observational study. The detailed medical history of the patients and the drugs they used were recorded. PPV monitoring was applied to the patients who were taken to the operating room. After returning to the prone position, patients with MAP below 55 mmHg on arterial monitoring or with a blood pressure reduction of more than 20 percent according to preoperatively measured MAP were in the hypotensive group Group H, 50 patients, the remaining patients were in the normotensive group Group N, 53 patients were divided into two groups. Demographic data, comorbidity frequencies, antihypertensive used, perioperative PPV values, ejection fraction rates, lung compliance and airway pressure values were compared between the two groups. The rate of comorbidity, diagnosis of hypertension, beta-blocker drug class, and high pre-induction PPV value were found to be statistically significantly higher in Group H. In addition, the mean age was higher and the rate of smoking was lower in Group H. No significant difference was detected in other demographic data. Ejection-fraction ratio was found to be significantly lower in Group H. There was no difference between the two groups in terms of lung compliance, peak inspiratory pressure, plateau pressure, and lung driving pressure. High PPV value, diagnosis of hypertension, use of beta-blocker can be counted among the reasons for the development of hypotension after repositioning in patients undergoing vertebral surgery that will return to the prone position.

 Hypotension may develop after returning from the supine position to the prone position in patients undergoing spine surgery. Intraoperative hypotension has been shown to be associated with serious complications. Our aim is to reveal the risk factors in the development of hypotension associated with position change in this patient group. 103 patients over the age of 18 who will undergo spinal surgery in the prone position under general anesthesia were included in our prospective, observational study. The detailed medical history of the patients and the drugs they used were recorded. PPV monitoring was applied to the patients who were taken to the operating room. After returning to the prone position, patients with MAP below 55 mmHg on arterial monitoring or with a blood pressure reduction of more than 20 percent according to preoperatively measured MAP were in the hypotensive group Group H, 50 patients, the remaining patients were in the normotensive group Group N, 53 patients were divided into two groups. Demographic data, comorbidity frequencies, antihypertensive used, perioperative PPV values, ejection fraction rates, lung compliance and airway pressure values were compared between the two groups. The rate of comorbidity, diagnosis of hypertension, beta-blocker drug class, and high pre-induction PPV value were found to be statistically significantly higher in Group H. In addition, the mean age was higher and the rate of smoking was lower in Group H. No significant difference was detected in other demographic data. Ejection-fraction ratio was found to be significantly lower in Group H. There was no difference between the two groups in terms of lung compliance, peak inspiratory pressure, plateau pressure, and lung driving pressure. High PPV value, diagnosis of hypertension, use of beta-blocker can be counted among the reasons for the development of hypotension after repositioning in patients undergoing vertebral surgery that will return to the prone position.

 Omurga cerrahisi geçiren hastalarda, supin pozisyondan pron pozisyona döndükten sonra hipotansiyon gelişebilmektedir. İntraoperatif hipotansiyonun kısa süreli olsa bile postoperatif ciddi komplikasyonlarla ilişkili olabilir. Amacımız bu hasta grubunda pozisyon değişikliği ile ilişkili hipotansiyon gelişimindeki risk faktörlerini ortaya koymaktır. Prospektif, gözlemsel çalışmamıza 18 yaş üstü, genel anestezi altında pron pozisyonda omurga cerrahisi geçirecek, 103 hasta dahil edildi. Hastaların perioperatif rutin monitörizasyon ve arteriyel kanülasyonundan sonra PPV monitörizasyonu uygulandı. Pron pozisyona döndükten sonra OAB 55 mmHgnin altında olan veya preoperatif ölçülen OABye göre yüzde 20den fazla düşen hastalar hipotansif grup Grup H, 50 hasta, geri kalan hastalar normotansif grup Grup N, 53 hasta olmak üzere iki gruba ayrıldı. Grupların demografik verileri, komorbidite sıklıkları, kullandığı antihipertansif ilaçlar, perioperatif PPV değerleri, ejeksiyon fraksiyon oranları, akciğer kompliyansları ve hava yolu basınç değerleri karşılaştırıldı. Grup Hde komorbidite varlığı, hipertansiyon olması, beta-blokör kullanılması, indüksiyon öncesi PPV değerinin yüksek olması istatistiksel anlamlı olarak daha yüksek bulundu. Ayrıca Grup Hde yaş ortalaması daha yüksek, sigara kullanım oranı daha düşüktü. Ejeksiyon fraksiyon oranı Grup Hde anlamlı olarak daha düşük saptandı. Akciğer kompliyansı, tepe inspirasyon basıncı, plato basıncı, akciğer sürücü basıncı arasında iki grup arasında fark tespit edilmedi. Hemoglobin değerleri, laktat seviyeleri, bazal GFR düzeyleri bakımından anlamlı farklılık saptanmadı. Genel anestezi indüksiyonuna bağlı gelişen hipotansiyondan bağımsız olarak, pron pozisyona dönecek olan vertebral cerrahi geçiren hastalarda PPV değerinin yüksek olması, hipertansiyon tanısının olması, beta-blokör kullanımı pozisyon değişikliği sonrası hipotansiyon gelişmesinin sebepleri arasında sayılabilir.

Makale detayları

Investigation of The Factors Predicted For Hypotension Developing After Position Change in Patients Which Was Performed in The Prone Position

Yazarlar:

Selim Can Yırtımcı | Seyda Efsun Ozgunay | Mehmet Gamlı

Yayıncı:

Karyay Karadeniz Yayımcılık

Ana Başlıklar:

Cerrahi (Diğer)

Dergi:

Black Sea Journal of Health Science Vol.7 Issue 6, pp.240-247

Belge Tipi:

Makale

Yayın Tarihi:

11/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001331261

pISSN:

2619-9041

Hypotension

Prone position

Vertebral surgery

PPVHipotansiyon

Pron pozisyon

Vertebral cerrahi

PPV

Sayı

Makale detayları

Yazarlar: Selim Can Yırtımcı | Seyda Efsun Ozgunay | Mehmet Gamlı

Yayıncı: Karyay Karadeniz Yayımcılık

Ana Başlıklar: Cerrahi (Diğer)

Dergi: Black Sea Journal of Health Science Vol.7 Issue 6, pp.240-247

Belge Tipi: Makale

Yayın Tarihi: 11/2024

Belge Dili: Türkçe

Document ID (Org No.): 2001331261

pISSN: 2619-9041

Sayı

Yazarlar:

Selim Can Yırtımcı | Seyda Efsun Ozgunay | Mehmet Gamlı

Yayıncı:

Karyay Karadeniz Yayımcılık

Ana Başlıklar:

Cerrahi (Diğer)

Dergi:

Black Sea Journal of Health Science Vol.7 Issue 6, pp.240-247

Belge Tipi:

Makale

Yayın Tarihi:

11/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001331261

pISSN:

2619-9041