Effect Of Postural Changes On Hemodynamics Inpatients With Different Ages After Induction Of General Anesthesia

Objective To observe the variation trends of hemodynamic indexes before and after posture changes in patients of posterior spinal surgery with different ages after inducement of general anesthesia,and to formulate the corresponding prevention and treatment strategies to improve the perioperative saf et yMethods Select 60 cases of spinal surgery in our hospital,age 20~80 yeas,male or female,ASAI~ Ⅱ,20 casesof youth group(20~4 4y),20 cases of middle-aged group(45~59y),20 cases of old group(60~80 y).Monitor and record the intraoperation hemod ynamic indexes of patients in 3 groups b y monitoring instrument and Flo Trac/Vigileo monitoring s ystem,record T 0(before induction of general anesthesia),T 1(after induction of general anesthesia),T 2(before prone position),T3(proneposition immediately),T 4(5min after proneposition)and T 5(10minafter proneposition),including HR,SBP,DBP,MAP,CVP,CO,CI,SV,SVI,SVV,SVR,SVRI,and record the usage time of vasoactive drugs.Results T2,T4,T5 and T3 were compared: HR of elderly and middle-aged group in T2 is more than T3,T4,T5(aged P<0.05);In three groups,SBP,DBP,MAP,CO,CI,SV,SVI in T 2 were higher than T3,T4,T5(P<0.05),CVP,SVV in T2 were lower than T3,T4,T5(P<0.05),all of them except CVP in elderl y group were significantly higher than other two groups;CVP of three groups was less than T3,T4,and T5(P<0.05);SVR,SVRI of three groups in T2 was less than T3(elderl y group P<0.05)(T2).Comparison T3 with T4: three groups of patientswith DBP,MAP,CO,CI,SV,SVI were increased(P<0.05),SVV were decreased(P<0.05),elderly patients change larger than the other two groups;SBP were higher in all three groups(elderly group and young group P<0.05),elderl y group changes larger than the other two groups;SVR and SVRI in three groups were decreased(elderly group P<0.05).Compared T4 with T5: In the elderl y group,SBP,DBP,MAP,CO,CI,SV,SVI showed an upward trend(P<0.05),SVV showed an downward trend(P<0.05).T3 and T5: three groups of patients with SBP,DBP,CO,CI,SV,SVI showed an upward trend(P<0.05),SVV showed an downward trend(P<0.05);the CVP of the patients in the three groups showed an upward trend(middle-aged group P<0.05)(MAP).Three groups of patients with SVR,SVR I showed a downward trend(elderly patients with P<0.05).Conclusion Prone position can lead the hemodynamic changes,and it cannot be avoided even in the premise of preventive infusions.The index in elderl y group was changes significantly.The main factor may be the decrease of venous return and amyocardial compliance.compared with HR,SBP,DBP,MAP;CO,CI,SV,SVI,SVV can accuratel y reflect the changes of h emod ynamics.