Korean J Anesthesiol.  2006 Dec;51(6):675-679. 10.4097/kjae.2006.51.6.675.

Effects of Patients' Position on Blood Pressure and Heart Rate during Spinal Anesthesia for Axillo-femoral Bypass Surgery

• Park SK
• Kim YK
• Chung SL
• Chin JH
• Lee C
• Lee YM

• KMID: 2243600
• DOI: http://doi.org/10.4097/kjae.2006.51.6.675

Abstract

BACKGROUND: Hypotension is one of the most common complications from the spinal anesthesia frequently used for surgery on the lower abdomen or extremities. It might be important in prognostic improvements to maintain cardiovascular homeostasis in elderly or patients with cardiovascular diseases. This study evaluated the effect of the patients' position on the preservation of cardiovascular stability when elderly patients suffering from hypertension undergo surgery for an axillo-femoral arterial bypass.
METHODS
24 patients with hypertension undergoing an elective axillo-femoral bypass surgery were examined. The patients were randomly allocated into two groups (Lateral 20 min group: patients with lateral position for 20 min after spinal anesthesia; Supine group: patients with the supine position immediately after spinal anesthesia). The observers recorded the hemodynamic variables, as well as the loss of sensation on both sides.
RESULTS
Considering the changes in the arterial blood pressure and heart rate from the baseline values, patients in the supine group showed a greater decrease in arterial blood pressure and heart rate (P < 0.05). In the lateral 20 min group, there was a lower block level of cold sensation that reflected the sympathetic blockade at the non-operated site (P < 0.05).
CONCLUSIONS
The lateral decubitus position for 20 min after spinal anesthesia can contribute to the maintenance of cardiovascular stability during unilateral axillo-femoral bypass surgery in elderly patients with hypertension.

Keyword

axillo-femoral bypass surgery; hypotension; spinal anesthesia

MeSH Terms

Abdomen
Aged
Anesthesia, Spinal*
Arterial Pressure
Blood Pressure*
Cardiovascular Diseases
Extremities
Heart Rate*
Heart*
Hemodynamics
Homeostasis
Humans
Hypertension
Hypotension
Sensation
Supine Position