Turk J Med Sci. 2014;44(2):317-22. doi: 10.3906/sag-1303-23.
BACKGROUND/AIM: There are limited data in the literature investigating the effects of anesthetic agents on cardiac output used in the chest-knee position. The aim of this study is to compare the effects of inhalation and total intravenous anesthesia on cardiac output in patients undergoing lumbar discectomy in the chest-knee position.
Forty patients undergoing discectomy in the chest-knee position were allocated to 2 groups. The first group (GrS, n = 20) received sevoflurane after thiopental induction, while the second group (GrP, n = 20) received propofol induction and infusion. Heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation, cardiac output (CO), and cardiac index (CI) were recorded.
Groups were comparable in terms of HR and MAP. The differences related to anesthetic technique and position were statistically significant within each group. Cardiac output and CI were similar between the groups. Cardiac output and CI of GrP were found to be decreased in the chest-knee position and significantly elevated in the supine position after surgery (P < 0.05). There were significant decreases in the mean CO and CI values recorded after the chest-knee position in GrP.
Sevoflurane is found to be superior when compared to propofol in patients undergoing surgery in the chest-knee position in terms of perioperative hemodynamic stability. Therefore, sevoflurane may be the anesthetic of choice, especially in patients operated on in the chest-knee position with suspected hemodynamic instability.
背景/目的：在胸部-膝盖位置下，用于研究麻醉剂对心输出量影响的文献数据有限。本研究旨在比较吸入麻醉和全静脉麻醉对胸部-膝盖位置下行腰椎间盘切除术患者心输出量的影响。
40 例在胸部-膝盖位置行椎间盘切除术的患者被分配到 2 组。第一组（GrS，n = 20）在硫喷妥钠诱导后接受七氟醚，而第二组（GrP，n = 20）接受丙泊酚诱导和输注。记录心率（HR）、平均动脉压（MAP）、外周血氧饱和度、心输出量（CO）和心指数（CI）。
两组的 HR 和 MAP 相当。与麻醉技术和体位相关的差异在每组内均具有统计学意义。两组之间 CO 和 CI 无差异。GrP 在胸部-膝盖位置时 CO 和 CI 降低，手术后仰卧位时显著升高（P < 0.05）。GrP 在胸部-膝盖位置后 CO 和 CI 的平均值显著降低。
在胸部-膝盖位置下手术的患者中，与丙泊酚相比，七氟醚在围手术期血流动力学稳定性方面表现更优。因此，七氟醚可能是首选麻醉剂，尤其是在怀疑血流动力学不稳定的患者中在胸部-膝盖位置下进行手术。
