Effect of patient positioning on anesthesiologic risk in endourological procedures.

IF 0.7 Q4 UROLOGY & NEPHROLOGY
Urology Annals Pub Date : 2023-07-01 Epub Date: 2023-06-16 DOI:10.4103/ua.ua_113_22
Theofanis Vrettos, Begona Ballesta Martinez, Arman Tsaturyan, Despoina Liourdi, Abdulrahman Al-Aown, Marco Lattarulo, Evangelos Liatsikos, Panagiotis Kallidonis
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Abstract

Objective: The objective is to compare supine and prone positions in terms of arterial blood gas during lithotripsy endourology procedures in different stages.

Material and methods: Cases of during lithotripsy endourology procedures in our department from March to September 2020 were included prospectively. The variables registered were body mass index, age, the American Society of Anesthesiologists (ASA) score, diabetes mellitus, positive end-expiratory pressure (PEEP), FiO2, stone size, stone location, procedural type, position, procedure duration, PaO2, SaO2, PaCO2, pH, and dynamic compliance. PaO2, SaO2, PaCO2, pH, and dynamic compliance were recorded at the beginning of the procedure, 5 min later, 15 min later, and at the end of the procedure.

Results: Thirty patients in prone position and 30 in lithotomy position were included in this study. Patients in prone position underwent percutaneous nephrolithotomy, and patients in supine/lithotomy underwent retrograde intrarenal surgery or ureteroscopy. Statistically significant differences were found in PEEP, duration, PaO2 at the beginning, SaO2 at the beginning and at the end of the procedure, PaCO2 at the beginning and at minute 5 and pH at the beginning of the surgery. The saturation PaO2 increased significantly on prone position and was statistically significantly better at the end of the surgery.

Conclusions: Both prone and supine positions were safe regarding anesthesiologic risk and had no clinically relevant differences in terms of individual comparisons in arterial blood gas parameters in static moments of the procedure. Prone position was related to an increase in PaO2 and a drop in PaCO2 gradually from the beginning to the end of the surgery.

Abstract Image

患者定位对泌尿外科手术麻醉风险的影响。
目的:比较不同阶段输尿管镜碎石术中仰卧位和俯卧位动脉血气的变化。材料和方法:前瞻性纳入2020年3月至9月在我科进行的碎石内泌尿外科手术的病例。登记的变量包括体重指数、年龄、美国麻醉师协会(ASA)评分、糖尿病、呼气末正压(PEEP)、FiO2、结石大小、结石位置、手术类型、位置、手术持续时间、PaO2、SaO2、PaCO2、pH和动态顺应性。在程序开始时、5分钟后、15分钟后和程序结束时记录PaO2、SaO2、PaCO2、pH和动态顺应性。结果:本研究包括30例俯卧位患者和30例取石位患者。俯卧位患者接受经皮肾取石术,仰卧位/取石位患者接受逆行肾内手术或输尿管镜检查。PEEP、持续时间、开始时的PaO2、手术开始时和结束时的SaO2、开始时和第5分钟的PaCO2以及手术开始时的pH值在统计学上存在显著差异。俯卧位的血氧饱和度显著增加,在手术结束时统计学上显著改善。结论:俯卧位和仰卧位在麻醉风险方面都是安全的,并且在手术静态时刻动脉血气参数的个体比较方面没有临床相关差异。从手术开始到结束,俯卧位与PaO2的增加和PaCO2的逐渐下降有关。
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来源期刊
Urology Annals
Urology Annals UROLOGY & NEPHROLOGY-
CiteScore
1.20
自引率
0.00%
发文量
59
审稿时长
31 weeks
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