Kim Jae Young, Kim Eun Joo, Lee Ji Hyang, Lee Sang Kon, Ban Jong Suk, Min Byung Woo
Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea.
Korean J Anesthesiol. 2009 Dec;57(6):768-772. doi: 10.4097/kjae.2009.57.6.768.
The prone position during anesthesia sometimes causes hemodynamic changes such as a decrease in blood pressure. These changes are caused by a decrease in venous return from venous pooling in the legs, and decreased left ventricular compliance secondary to increased intrathoracic pressure, when patients are placed prone with an Andrews frame. We report on a patient who experienced cardiac arrest in the prone position with the Andrews frame during lumbar laminectomy and posterior lumbar interbody fusion. After 1.25 h in the prone position, bradycardia and hypotension occurred. Ephedrine, atropine and epinephrine were infused intravenously, but bradycardia and hypotension progressed to asystole. Cardioinhibitory reflex was likely triggered by decreased venous return and increased intrathoracic pressure, and the patient developed cardiac arrest as a result.
麻醉期间的俯卧位有时会引起血流动力学变化，如血压下降。这些变化是由于患者使用安德鲁斯框架俯卧时，腿部静脉淤积导致静脉回流减少，以及胸内压升高继发左心室顺应性降低所致。我们报告了1例在腰椎椎板切除术和后路腰椎椎间融合术中使用安德鲁斯框架俯卧位时发生心脏骤停的患者。俯卧位1.25小时后，出现心动过缓和低血压。静脉注射麻黄碱、阿托品和肾上腺素，但心动过缓和低血压进展为心搏停止。心脏抑制反射可能是由静脉回流减少和胸内压升高触发的，患者最终发生了心脏骤停。
