Haemodynamic effects of the prone position: a comparison of propofol total intravenous and inhalation anaesthesia.

Author(s): Sudheer PS, Logan SW, Ateleanu B, Hall JE

Affiliation(s): Lecturer, University of Wales College of Medicine, Heath Park Cardiff, CF14 4XN, UK.

Publication date & source: 2006-02, Anaesthesia., 61(2):138-41.

Publication type:

Summary The haemodynamic changes of the prone position were investigated in 40 ASA I-II patients undergoing lumbar spine surgery. Patients were randomly assigned, following propofol intravenous induction, to receive maintenance of anaesthesia using either isoflurane 1-1.2% in air or target controlled propofol 3 mug.ml(-1) infusion. Measurements of non-invasive blood pressure, heart rate and cardiac output were made in the supine position. The patient was then turned prone onto a Montreal pattern mattress and measurements repeated. Cardiac output measurements were made using a non-invasive cardiac output monitor. We found a significant reduction in cardiac index in both groups and a significantly greater change with propofol compared to isoflurane on turning supine to prone (CI change 0.4 vs 0.7 l.min(-1).m(-2) p = 0.001 and SVRI change 89 vs 177 dyne.s(-1).cm(-5), p = 0.041). We conclude that turning healthy patients prone produces a clinically significant reduction in cardiac output, the change being greater during maintenance of anaesthesia using propofol compared to isoflurane.