Yokoyama M, Ueda W, Hirakawa M
Department of Anaesthesiology and Resuscitology, Okayama University Medical School, Japan.
Br J Anaesth. 2000 Jun;84(6):753-7. doi: 10.1093/oxfordjournals.bja.a013588.
We measured the haemodynamic effects of changing from the supine position to the lateral decubitus (lateral) position, and then to the kidney rest lateral decubitus (kidney) position in 12 patients undergoing nephrectomy under isoflurane anaesthesia. Eight control patients undergoing pulmonary surgery remained in the lateral position. The lateral position produced no significant changes. In the kidney position, however, significant reductions occurred in the mean arterial (P < 0.01), right atrial (P < 0.05) and pulmonary artery wedge pressures (P < 0.01). There were also significant reductions in cardiac index (from 3.04 (SD 0.21) to 2.44 (0.26) litre min-1 m-2, P < 0.01) and stroke volume index (from 40 (5) to 31 (5) ml beat-1 m-2, P < 0.01). The systemic vascular resistance index increased significantly (P < 0.05). Cardiac output was probably reduced by a decrease in venous return and an increase in systemic vascular resistance.
我们测量了12例在异氟烷麻醉下接受肾切除术的患者从仰卧位改为侧卧位，然后再改为肾托侧卧位时的血流动力学效应。8例接受肺部手术的对照患者保持侧卧位。侧卧位未产生显著变化。然而，在肾托侧卧位时，平均动脉压（P<0.01）、右心房压（P<0.05）和肺动脉楔压（P<0.01）显著降低。心脏指数（从3.04（标准差0.21）降至2.44（0.26）升·分钟-1·米-2，P<0.01）和每搏量指数（从40（5）降至31（5）毫升·搏-1·米-2，P<0.01）也显著降低。全身血管阻力指数显著升高（P<0.05）。心输出量可能因静脉回流减少和全身血管阻力增加而降低。
