Cardiac Output and Other Hemodynamic Changes With Prone Position in Cervical Myelopathy Patients Undergoing Surgery

Dhritiman Chakrabarti30 enrolled

Overview

Positioning a patient in prone position under anaesthesia significantly alters cardiovascular physiology. Cervical myelopathy patients are known to have autonomic dysfunction. Such patients when positioned in prone position under anaesthesia carry a higher risk of developing hemodynamic changes and this can compromise spinal cord perfusion. This prospective observational study was conducted on 30 patients with cervical myelopathy who underwent surgery in prone position at NIMHANS, Bangalore hospital. The non invasive cardiac output monitor (NICOM, Cheetah Medicals) was used to record various hemodynamic parameters. The hemodynamic parameters were recorded at baseline, post induction, post intubation, prior to prone position, post prone position, and every five minutes thereafter upto 20mins. The hemodynamic parameters that were recorded using the NICOM monitor: * HR - Heart rate (beats /min) * NIBP - non invasive blood pressure (mmHg) * MAP - mean arterial pressure(mmHg) * CO - cardiac output (l/min) * CI - cardiac index (l/min/m2) * SV - Stroke volume (ml/beat) * SVV -stroke volume variability (%) * TPR - total peripheral resistance (dynes. sec/cm5)

Study Type

OBSERVATIONAL

Enrollment

Conditions

Hemodynamics Instability

Interventions

Prone Positioning

Outcomes

Primary Outcomes

Mean arterial pressure

Analysis of change in mean arterial pressure at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning.