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Article in Chinese | WPRIM | ID: wpr-823657

ABSTRACT

Objective To compare the changes in cardiac output (CO) and other hemodynamic parameters in patients undergoing gynecological laparoscopic surgery in head-down lithotomy position and Trendelenburg position. Methods Sixty patients were divided into head-down lithotomy group and Trendelenburg group. CO was recorded as baseline by a noninvasive cardiac output monitor NICOM? system after the placement of patients. These measurements were also acquired when the patients were placed in the 30° head-down tilt(T0)following pneumoperitoneum establishment.Stroke volume(SV), heart rate(HR)and CO were monitored at 1-minute intervals thereafter for a total of 10 minutes(T1-T10),and mean arterial pressure(MAP)and total peripheral resistance(TPR)were monitored every 5 minutes. Results The reduction of CO in head-down lithotomy group was greater than that in Trendelenburg group(T0:-31%±19% vs.-9%±34%;T1:-32%±18% vs.-16%±38%;T2:-33%± 19%vs.-16%±26%;T3:-32%±22%vs.-16%±28%;T4:-31%±18%vs.-12%±38%;T5:-30%± 17%vs.-14%±37%;T6:-31%±17% vs.-14%±33%,all P<0.05)during the first 6 minutes. MAP at baseline in head-down lithotomy group was significantly higher than that in Trendelenburg group[(97±11) mmHg vs.(85±6)mmHg,P<0.05].MAP decreased in head-down lithotomy group at T0(-8%±16%) and increased in Trendelenburg group at T5 and T10(T5:9%±15%,T10:12%±18%). Conclusion CO reduction was greater in patients in head-down lithotomy position than that in Trendelenburg position group during the first 10 minutes after adjusting the position following pneumoperitoneum establishment.

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