J Clin Monit Comput - Prediction of hypotension in the beach chair position during shoulder arthroscopy using pre-operative hemodynamic variables.

Tópicos

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Resumo

Since hypotension in beach chair position (BCP) can lead to catastrophic neurologic complications, the prediction of hypotension is a matter of concern in the BCP under general anesthesia. We investigated whether pre-induction values of mean arterial pressure (MAP), stroke volume variation (SVV), cardiac index (CI), and stroke volume index (SVI) can predict hypotension in BCP during general anesthesia. Forty healthy adult patients, aged 18-65 years, undergoing elective arthroscopic shoulder surgery, were enrolled. At 5 min after anesthesia induction, patients were placed in the 70? upright position. Receiver operating characteristic (ROC) curves were plotted for preoperative hemodynamic variables, including MAP, SVV, CI and SVI, and their abilities to predict hypotension were investigated. Fifteen patients developed hypotension after being moved from the supine to the BCP. The areas under the ROC curves for pre-induction values of MAP, CI, and SVI and post-induction value of SVV before a positional change were 0.556 (95% CI 0.373-0.739; p = 0.557), 0.735 (0.576-0.894; p = 0.014), 0.787 (0.647-0.926; p = 0.003), and 0.691 (0.525-0.857; p = 0.046), respectively. In this study, pre-induction values of CI and SVI and post-induction value of SVV before a positional change predicted hypotension in the BCP under general anesthesia. Our findings suggest that not only preload but also preoperative cardiac performances might be the important factors for the development of hypotension after a repositioning supine to the sitting during general anesthesia.

Resumo Limpo

sinc hypotens beach chair posit bcp can lead catastroph neurolog complic predict hypotens matter concern bcp general anesthesia investig whether preinduct valu mean arteri pressur map stroke volum variat svv cardiac index ci stroke volum index svi can predict hypotens bcp general anesthesia forti healthi adult patient age year undergo elect arthroscop shoulder surgeri enrol min anesthesia induct patient place upright posit receiv oper characterist roc curv plot preoper hemodynam variabl includ map svv ci svi abil predict hypotens investig fifteen patient develop hypotens move supin bcp area roc curv preinduct valu map ci svi postinduct valu svv posit chang ci p p p p respect studi preinduct valu ci svi postinduct valu svv posit chang predict hypotens bcp general anesthesia find suggest preload also preoper cardiac perform might import factor develop hypotens reposit supin sit general anesthesia

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