Comparative utility of centrally versus peripherally transduced venous pressure monitoring in the perioperative period in spine surgery patients.

ABSTRACT

STUDY OBJECTIVE: To compare central venous pressure (CVP) with peripheral venous pressure (PVP) monitoring during the intraoperative and postoperative periods in patients undergoing spine surgery. DESIGN: Prospective observational study. SETTING: University-affiliated teaching hospital. PATIENTS 35 ASA physical status 1, 2, and 3 patients. INTERVENTIONS: A peripheral catheter in the forearm or hand and a central catheter into the internal jugular vein were placed for PVP and CVP monitoring, respectively. MEASUREMENTS CVP and PVP values were collected simultaneously and recorded electronically at 5-minute intervals throughout surgery and in the recovery room. The number of attempts for catheter placement, ease of use, maintenance, and interpretation were recorded. Patient comfort, frequency of complications, and cost were analyzed. MAIN RESULTS: The correlation coefficient between CVP and PVP was 0.650 in the operating room (P < 0.0001) and 0.388 in the recovery room (P < 0.0001). There was no difference between groups in number of attempts to place either catheter, maintenance, and interpretation with respect to PVP and CVP monitoring in the operating room. In the recovery room, the nurses reported a higher level of difficulty in interpretation of PVP than CVP, but no differences were noted in ease of maintenance. There were no complications related to either central or peripheral catheter placement. Patient comfort and cost efficiency were higher with a peripheral than a central catheter. CONCLUSION: During clinically relevant conditions, there was limited correlation between PVP and CVP in the prone position during surgery and postoperatively in the recovery room.